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Persistent and moderate hypercalcemia related to an ovarian clear cell adenocarcinoma: Pre- and postoperative parathyroid hormone related-peptide and 1,25-dihydroxyvitamin D3 levels

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Abstract

Objective: To evaluate the role of PTH-related peptide (PTH-rP) and 1,25-dihyhydroxyvitamin D3 in a case of hypercalcemia related to an ovarian adenocarcinoma. Design: We report a case of humoral hypercalcemia in a patient aged 74 yr with a clear cell adenocarcinoma of the right ovary at an early stage of its development (stage T1aN0M0) revealed by moderate and persistent hypercalcemia (variable level between 2.7 and 3.2 mmol/l without any treatment) over six months. Methods: PTH-rP and 1,25-dihydroxyvitamin D3 were measured in blood samples taken before and after hysterectomy and bilateral salpingo-oophorectomy and in blood samples taken intraoperatively from the right ovarian vein and a peripheral vein. Results: High levels of plasma PTH-rP and 1,25-dihydroxyvitamin D3 concomitant with high serum calcium and low PTH levels were found before surgery, which was followed by normalisation of all parameters studied. A concentration gradient was found regarding plasma PTH-rP (right ovarian vein 60.4 pmol/l, peripheral vein 4.5 pmol/l), not 1,25-dihydroxyvitamin D3. Conclusion: 1) moderate and persistent hypercalcemia can be observed at an early stage of an ovarian carcinoma; 2) the gradient of PTH-rP concentration between the samples taken from the right ovarian vein and a peripheral vein provides evidence for a direct secretion of PTH-rP by the ovarian tumor; 3) the increased 1,25-dihydroxyvitamin D3 level is not related to a direct ovarian production, but is a consequence of PTH-rP secretion.

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Authors and Affiliations

  1. Service d’Endocrinologie, Hôpital Rangueil, France

    A. Benit, D. Vezzosi, F. Donadille, A. Bennet & P. Caron

  2. Laboratoire d’Exploration Fonctionnelle Rénale, Hôpital Rangueil, France

    J. Allard

  3. Service de Chirurgie Générale et Gynécologique, Hôpital Rangueil, France

    J. Rimailho

  4. Laboratoire de Biochimie III, Hôpital La Grave, France

    J. Fauvel

  5. Laboratoire d’Anatomie et Cytologie Pathologiques, Hôpital Purpan, Toulouse, France

    G. Escourrou

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Benit, A., Allard, J., Rimailho, J. et al. Persistent and moderate hypercalcemia related to an ovarian clear cell adenocarcinoma: Pre- and postoperative parathyroid hormone related-peptide and 1,25-dihydroxyvitamin D3 levels. J Endocrinol Invest 29, 443–449 (2006). https://doi.org/10.1007/BF03344128

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