Surgery Today

, Volume 35, Issue 8, pp 692–695

Humoral Hypercalcemia Complicating Adenocarcinoma of the Sigmoid Colon: Report of a Case

  • Jun Sakata
  • Toshifumi Wakai
  • Yoshio Shirai
  • Eiko Sakata
  • Go Hasegawa
  • Katsuyoshi Hatakeyama
Article

Abstract

Humoral hypercalcemia can arise from a variety of malignancies, but its association with primary colorectal carcinoma is rare, with only 20 such cases documented in the English-language literature to date. We report an additional case to clarify the clinicopathologic features of colorectal carcinoma with humoral hypercalcemia. A 54-year-old woman was admitted with symptomatic hypercalcemia of 14.2 mg/dl and multiple hepatic metastases, 2 years after resection of sigmoid colon cancer. The hypercalcemia was caused by the circulating parathyroid hormone-related peptide (PTHrP) produced by poorly differentiated adenocarcinoma in the liver. The PTHrP level on admission was 13.5 pmol/l. Despite systemic chemotherapy, the patient died of disease progression 3 weeks after the humoral hypercalcemia was diagnosed. A review of the 21 reported cases, including ours, suggests that colorectal carcinoma associated with humoral hypercalcemia is characterized by a poorly differentiated tumor with or without squamous or neuroendocrine features, distant metastases, and a dismal prognosis.

Key words

Humoral hypercalcemia of malignancy Parathyroid hormone-related peptide Paraneoplastic syndrome Colorectal neoplasm Prognosis 

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References

  1. 1.
    Wysolmerski, JJ, Broadus, AE 1994Hypercalcemia of malignancy: the central role of parathyroid hormone-related proteinAnnu Rev Med45189200CrossRefPubMedGoogle Scholar
  2. 2.
    Castleman, B, Kibbee, BU 1963Case records of the Massachusetts General Hospital: case 63-1963N Engl J Med2698018PubMedGoogle Scholar
  3. 3.
    Mozaffarian, G 1969Hypercalcemia associated with malignancies unexplained by bone metastasis. Case reports and review of literatureJ Maine Med Assoc602057PubMedGoogle Scholar
  4. 4.
    Omenn, GS, Roth, SI, Baker, WH 1969Hyperparathyroidism associated with malignant tumors of nonparathyroid originCancer24100412PubMedGoogle Scholar
  5. 5.
    Kubota, H, Koyama, Y, Hojo, K, Shimamura, Y, Onishi, T, Tanaka, M,  et al. 1980Adenosquamous cell carcinoma of the colon with severe hypercalcemia. Report of two casesJpn J Clin Oncol1031120Google Scholar
  6. 6.
    Palvio, DH, Sorensen, FB, Klove-Mogensen, M 1985Stem cell carcinoma of the colon and rectum. Report of two cases and review of the literatureDis Colon Rectum284405PubMedGoogle Scholar
  7. 7.
    Chevinsky, AH, Berelowitz, M, Hoover, HC,Jr 1987Adenosquamous carcinoma of the colon presenting with hypercalcemiaCancer6011116PubMedGoogle Scholar
  8. 8.
    Berkelhammer, CH, Baker, AL, Block, GE, Bostwick, DG, Michelassi, F 1989Humoral hypercalcemia complicating adenosquamous carcinoma of the proximal colonDig Dis Sci341427CrossRefPubMedGoogle Scholar
  9. 9.
    March, R, Ulin, R, Puccio, C, Savino, J, Arlin, Z, Ahmed, T,  et al. 1991Hypercalcemia associated with adenocarcinoma of the rectum. A case report and review of the literatureAnticancer Res11202930PubMedGoogle Scholar
  10. 10.
    Gurney, H, Grill, V, Martin, TJ 1993Parathyroid hormone-related protein and response to pamidronate in tumor-induced hypercalcemiaLancet34116113CrossRefPubMedGoogle Scholar
  11. 11.
    Links, M, Ho, H, Clingan, P, Diamond, T 1994Hypercalcemia in a patient with fatal adenosquamous carcinoma of the colonMed J Aust1602867PubMedGoogle Scholar
  12. 12.
    de Souza, PL, Friedlander, ML 1995Humoral hypercalcemia associated with adenocarcinoma of the rectum. A case report and review of the literatureAm J Clin Oncol181269PubMedGoogle Scholar
  13. 13.
    Sidler, B, Alpert, L, Henderson, JE, Deckelbaum, R, Amizuka, N, Silva, JE,  et al. 1996Amplification of the parathyroid hormone-related peptide gene in a colonic carcinomaJ Clin Endocrinol Metab8128417CrossRefPubMedGoogle Scholar
  14. 14.
    Petrelli, NJ, Valle, AA, Weber, TK, Rodriguez-Bigas, M 1996Adenosquamous carcinoma of the colon and rectumDis Colon Rectum3912658PubMedGoogle Scholar
  15. 15.
    Sekine, M, Takami, H 1998Combination of calcitonin and pamidronate for emergency treatment of malignant hypercalcemiaOncol Rep51979PubMedGoogle Scholar
  16. 16.
    Lortholary, AH, Cadeau, SD, Bertrand, GM, Guerin-Meyer, VI, Gamelin, EC, Audran, MJ 1999Humoral hypercalcemia in patients with colorectal carcinoma: report of two cases and review of the literatureCancer86221721CrossRefPubMedGoogle Scholar
  17. 17.
    Thompson, JT, Paschold, EH, Levine, EA 2001Paraneoplastic hypercalcemia in a patient with adenosquamous cancer of the colonAm Surg675858PubMedGoogle Scholar
  18. 18.
    Luh, JY, Han, ES, Simmons, JR, Whitehead, RP 2002Poorly differentiated colon carcinoma with neuroendocrine features presenting with hypercalcemia and cutaneous metastases: case report and review of the literatureAm J Clin Oncol251603CrossRefPubMedGoogle Scholar
  19. 19.
    Bilezikian, JP 1992Management of acute hypercalcemiaN Engl J Med3261196203PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 2005

Authors and Affiliations

  • Jun Sakata
    • 1
  • Toshifumi Wakai
    • 1
  • Yoshio Shirai
    • 1
  • Eiko Sakata
    • 1
  • Go Hasegawa
    • 2
  • Katsuyoshi Hatakeyama
    • 1
  1. 1.Divisions of Digestive and General SurgeryNiigata University Graduate School of Medical and Dental SciencesNiigataJapan
  2. 2.Divisions of PathomorphologyNiigata University Graduate School of Medical and Dental SciencesNiigataJapan

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