Summary
In a case of pancreatic endocrine carcinoma hypercalcaemia without bone metastases and normal parathyroid glands prompted our suspicion that there was paraneoplastic production of an osteoclast activating substance by the tumour tissue. This view was further confirmed by bone histology. Immunohistology post mortem revealed the production of PTH in the primary tumour and a liver metastasis. The usefulness of immunohistology in detecting paraneoplastic secretion of hormonal substances is discussed.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Arps H, Dietel M (1984) Immunocytochemical demonstration of paraneoplastically secreted calcium regulating hormones. The Parathyroid Conferences, Cobe, Japan:46
Arps H, Dietel M, Otto U (1984a) Immunohistochemistry in detection of paraneoplastic secretion of calcium regulating hormones. Folia Histochem Cytobiol 22:173–178
Arps H, Dietel M, Otto U (1984b) Immunohistochemical studies on the paraneoplastic secretion of calcium regulating hormones by malignant tumors. Acta Endocrinol (Kbh) Suppl 264:98
Besarab A, Caro JF (1978) Mechanisms of hypercalcemia in malignancy. Cancer 41:2276–2285
Buckle RM, McMillan M, Mallinson C (1970) Ectopic secretion of parathyroid hormone by a renal cell adenocarcinoma in a patient with hypercalcemia. Br Med J 4:724–726
Delling G (1981) Morphology of tumor osteolysis in primary and secondary bone tumors. In: Calcitonina e Osteolisi Neoplastiche. Amour Medicamenta SD p A, Mailand, pp 1–10
Delling G (1982) Morphologie der Skelettmetastasen. In: Wolter D (ed) Osteolysen Pathologische Frakturen. Thieme-Verlag, Stuttgart-New York, pp 15–24
Dietel M (1982) Funktionelle Morphologie und Pathologic der Nebenschilddrfisen. G. Fischer-Verlag, Stuttgart-New York
Dietel M, Hölzel F (1983) Influence on parathyroid hormone storage in normal and adenomatous parathyroid tissue by stimulation and inhibition in vitro. J Histochem Cytochem 31:275–284
Dietel M, Dorn G, Montz R, Altenähr E (1979) Influence of vitamin D3, 1,25-dihydroxyvitamin D3, and 24,25-dihydroxyvitamin D3 on parathyroid hormone secretion, adenosine 3′,5′-monophosphate release, and ultrastructure of parathyroid glands in organ culture. Endocrinology 105:237–245
Gordan GS, Cantino TJ, Ehrhardt L, Hansen J, Lubich W (1966) Osteolytic sterol in human breast cancer. Science 151:1226–1228
Greenberg PB, Martin TJ, Sutcliffe HS (1973) Synthesis and release of parathyroid hormone by a renal carcinoma in cell culture. Clin Sci Mol Med 45:183–191
Heitz PhU, Oberholzer M (1984) Ectopic hormone production by tumors. In: DeLellis RA (ed) Advances of immunohistochemistry. Mason Publishing Inc, New York, pp 150–183
Heitz PhU, Staub JJ (1981) Paraneoplastische endokrine Syndrome. In: Doerr W, Seifert G (eds) Spezielle pathologische Anatomie Bd. 14. Springer-Verlag, Berlin-Heidelberg-New York, pp 1206–1272
Klöppel G, Girard J, Polak JM, Vaitukaitis JJ, Kaspar M, Heitz PhU (1983) Alpha-human chorionic gonadotropin and neuron-specific enolase as markers for malignancy and neuroendocrine nature of pancreatic endocrine tumors. Cancer Detect Prev 6:161–166
Marangos PJ (1985) Clinical utility of neuron specific enolase as a neuroendocrine tumour marker. In: Polak JM, Bloom SR (eds) Endocrine Tumours. Churchill Livingstone, Edinbourgh-London-Melbourne-New York, pp 181–192
Monno S, Nagata A, Homma T, Oguchi H, Kawa S, Kaji R, Furuta S (1984) Exocrine pancreatic cancer with humoral hypercalcemia. Am J Gastroenterol 79:128–132
Palmieri GMA, Nordquist RE, Omenn GS (1974) Immunochemical localization of parathyroid hormone in cancer tissue from patients with ectopic hyperparathyroidism. J Clin Invest 53:1726–1735
Rees LH (1975) The biosynthesis of hormones by non-endocrine tumors. J Endocrinol 67:143–175
Riggs BL, Arnaud CD, Reynolds JC, Smith LH (1971) Immunological differentiation of primary hyperparathyroidism from hyperparathyroidism due to nonparathyroid cancer. J Clin Invest 50:2079–2083
Samaan NA, Hickey RC, Sethi MR, Yang KP, Wallace S (1976) Hypercalcemia in patients with known malignant disease. Surgery 80:382–389
Sternberger LA (1976) Immunocytochemistry, 2. Ed. J. Whiley & Sons, New York
Tashjian AH, Levine L, Munson Pl (1964) Immunochemical identification of parathyroid hormone in non-parathyroid neoplasms associated with hypercalcemia. J Exp Med 119:467–484
Author information
Authors and Affiliations
Additional information
With support of the Deutsche Forschungsgemeinschaft, grant Di 276/1-1
Rights and permissions
About this article
Cite this article
Arps, H., Dietel, M., Schulz, A. et al. Pancreatic endocrine carcinoma with ectopic PTH-production and paraneoplastic hypercalcaemia. Vichows Archiv A Pathol Anat 408, 497–503 (1986). https://doi.org/10.1007/BF00705303
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00705303