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Hypercalcemia of Malignancy Induced by Parathyroid Hormone-related Protein in a Patient with Medullary Thyroid Carcinoma

Yıl 2007, Cilt: 14 Sayı: 4, 263 - 266, 01.08.2007

Öz

We present the case of a 50-year-old male patient presenting with a mass lesion in the neck region and diarrhea. Histological examination of the excisional biopsy specimen revealed medullary thyroid carcinoma. In the laboratory examination of the patient marked hypercalcemia was detected along with a low parathyroid hormone (PTH) levels (<1 pg/ml, (normal range: 10-69 pg/ml). PTH-related protein (PTHrP) level was elevated (8.5 pmol/L, normal range: <1.3 pmol/L). An extensive metastasis screening found metastatic lesions in the liver while no bone metastasis was discovered. The patient died shortly after induction of chemotherapy due to respiratory failure. To the best of our knowledge, this is the first reported case of a PTHrP-producing medullary carcinoma of the thyroid associated with humoral hypercalcemia of malignancy. Key words: Humoral hypercalcemia of malignancy, parathyroid hormone-related protein, medullary thyroid carcinoma

Kaynakça

  • Wysolmerski JJ, Broadus AE. Hypercalcemia of malignancy: the central role of parathyroid hormone-related protein. Annu Rev Med. 1994;45:189-200.
  • Clines GA, Guise TA. Hypercalcemia of malignancy and basic research on mechanisms responsible for osteolytic and osteoblastic metastasis to bone. Endocr Relat Cancer 2005;12:549-83.
  • Orlandi F, Caraci P, Mussa A, Saggiorato E, Pancani G, Angeli A. Treatment of medullary thyroid carcinoma: an update. Endocr Relat Cancer 2001;8:135-47.
  • Barrowman JA, Bennett A, Hillenbrand P, Rolles K, Pollock DJ, Wright JT. Diarrhoeae in thyroid medullary carcinoma: role of prostaglandins and therapeutic effect of nutmeg. Br Med J 1975;3:11-2.
  • Smallridge RC, Bourne K, Pearson BW, Van Heerden JA, Carpenter PC, Young WF. Cushing's syndrome due to medullary thyroid carcinoma: diagnosis by proopiomelanocortin messenger ribonucleic acid in situ hybridization. J Clin Endocrinol Metab 2003;88:4565-8.
  • Shuey KM. Hypercalcemia of malignancy: Part I. Clin J Oncol Nurs 2004;8:209-10.
  • Nakashima M, Ohtsuru A, Luo WT, Nakayama T, Enomoto H, Usa T, Kiriyama T, Ito M, Nagataki S, Yamashita S. Expression of parathyroid hormone-related peptide in human thyroid tumours. J Pathol 1995;175:227-36.
  • Yazawa S, Toshimori H, Nakatsuru K, Katakami H, Takemura J, Matsukura S. Thyroid anaplastic carcinoma producing granulocyte-colony-stimulating factor and parathyroid hormone-related protein Intern Med 1995;34:584-8.
  • Iwai H, Ohno Y, Aoki N. Anaplastic thyroid carcinoma with humoral hypercalcemia of malignancy (HHM): an autopsy case report. Endocr J 2004;51:303-10.
  • Ito Y, So T, Murayama M, Yasuda K, Miura K, Katakami H. Two cases of papillary thyroid carcinoma with hypercalcemia and increased serum parathyroid hormone- related peptide-like immunoreactivity (PTHrP-LI). Hormone to Rinsho 1993;41:109- 14 (in Japanese).
  • Saito K, Kuratomi Y, Yamamoto K, Saito T, Kuzuya T, Yoshida S, Moriyama SI, Takahashi A. Primary squamous cell carcinoma of the thyroid associated with marked leukocytosis and hypercalcemia. Cancer 1981;48:2080-3.
  • Riddle PE, Dincsoy HP. Primary squamous cell carcinoma of the thyroid associated with leukocytosis and hypercalcemia. Arch Pathol Lab Med 1987;111:373-4.
  • Ikeda K, Weir EC, Mangin M, Dannies PS, Kinder B, Deftos LJ, Brown EM, Broadus AE. Expression of messenger ribonucleic acids encoding a parathyroid hormone-like peptide in normal human and animal tissues with abnormal expression in human parathyroid adenomas. Mol Endocrinol 1988;2:1230-6.
  • Deftos LJ, Gazdar AF, Ikeda K, Broadus AE. The parathyroid hormone-related protein associated with malignancy is secreted by neuroendocrine tumors. Mol Endocrinol 1989;3:503-8.
  • Zabel M, Seidel J, Kaczmarek A, Surdyk-Zasada J, Grzeszkowiak J, Gorny A. Immunocytochemical characterization of two thyroid medullary carcinoma cell lines in vitro. Histochem J 1995;27:859-68.
  • Welbourn RB. Current status of the apudomas. Ann Surg 1977;185:1-12.
  • Deftos LJ, Parthemore JG. Secretion of parathyroid hormone in patients with medullary thyroid carcinoma. J Clin Invest 1974;54:416-20.
  • Markovitz M. Medullary carcinoma of the thyroid with hypercalcitoninemia and hypocalcemia. Ariz Med 1971;28:26-7.
  • Wysolmerski JJ, Vasavada R, Foley J, et al. Transactivation of the PTHrP gene in squamous carcinomas predicts the occurence of hypercalcemia in athymic mice. Cancer Res 1996;56:1043-9.
  • Corresponding Author: Dr. Kerem OKUTUR
  • Mazıdağı State Hospital,
  • Mazıdagi, Mardin 47770, Turkey. Phone : 505 7190165 Fax : 482 5111014
  • Email : keremokutur007@yahoo.com

Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu

Yıl 2007, Cilt: 14 Sayı: 4, 263 - 266, 01.08.2007

Öz

Burada boyunda kitle ve diyare ile başvuran 50 yaşında bir erkek hastayı sunduk. Kitleden alınan eksizyonel biopsi örneğinin histolojik incelemesinde meduller tiroid karsinomu saptandı. Gelişindeki laboratuvar tetkiklerinde belirgin hiperkalsemi saptanan hastanın serum paratiroid hormon (PTH) düzeyi <1 pg/ml (normal: 10-69), PTH-ilişkili protein (PTHrP) düzeyi ise 8.5 pmol/L (normal: <1.3) bulundu, ayrıca karaciğerde metastaz saptandı, kemik metastazı tespit edilmedi. Kemoterapi başlanan hastanın durumu progressif olarak kötüleşti ve solunum yetmezliği nedeniyle kaybedildi. Olgumuz literatürde PTHrP üretimine bağlı malign humoral hiperkalseminin nedeni olarak bildirilen ilk meduller tiroid karsinomu olgusudur. Anahtar kelimeler: Malign humoral hiperkalsemi, paratiroid hormon ilişkili protein, meduller tiroid

Kaynakça

  • Wysolmerski JJ, Broadus AE. Hypercalcemia of malignancy: the central role of parathyroid hormone-related protein. Annu Rev Med. 1994;45:189-200.
  • Clines GA, Guise TA. Hypercalcemia of malignancy and basic research on mechanisms responsible for osteolytic and osteoblastic metastasis to bone. Endocr Relat Cancer 2005;12:549-83.
  • Orlandi F, Caraci P, Mussa A, Saggiorato E, Pancani G, Angeli A. Treatment of medullary thyroid carcinoma: an update. Endocr Relat Cancer 2001;8:135-47.
  • Barrowman JA, Bennett A, Hillenbrand P, Rolles K, Pollock DJ, Wright JT. Diarrhoeae in thyroid medullary carcinoma: role of prostaglandins and therapeutic effect of nutmeg. Br Med J 1975;3:11-2.
  • Smallridge RC, Bourne K, Pearson BW, Van Heerden JA, Carpenter PC, Young WF. Cushing's syndrome due to medullary thyroid carcinoma: diagnosis by proopiomelanocortin messenger ribonucleic acid in situ hybridization. J Clin Endocrinol Metab 2003;88:4565-8.
  • Shuey KM. Hypercalcemia of malignancy: Part I. Clin J Oncol Nurs 2004;8:209-10.
  • Nakashima M, Ohtsuru A, Luo WT, Nakayama T, Enomoto H, Usa T, Kiriyama T, Ito M, Nagataki S, Yamashita S. Expression of parathyroid hormone-related peptide in human thyroid tumours. J Pathol 1995;175:227-36.
  • Yazawa S, Toshimori H, Nakatsuru K, Katakami H, Takemura J, Matsukura S. Thyroid anaplastic carcinoma producing granulocyte-colony-stimulating factor and parathyroid hormone-related protein Intern Med 1995;34:584-8.
  • Iwai H, Ohno Y, Aoki N. Anaplastic thyroid carcinoma with humoral hypercalcemia of malignancy (HHM): an autopsy case report. Endocr J 2004;51:303-10.
  • Ito Y, So T, Murayama M, Yasuda K, Miura K, Katakami H. Two cases of papillary thyroid carcinoma with hypercalcemia and increased serum parathyroid hormone- related peptide-like immunoreactivity (PTHrP-LI). Hormone to Rinsho 1993;41:109- 14 (in Japanese).
  • Saito K, Kuratomi Y, Yamamoto K, Saito T, Kuzuya T, Yoshida S, Moriyama SI, Takahashi A. Primary squamous cell carcinoma of the thyroid associated with marked leukocytosis and hypercalcemia. Cancer 1981;48:2080-3.
  • Riddle PE, Dincsoy HP. Primary squamous cell carcinoma of the thyroid associated with leukocytosis and hypercalcemia. Arch Pathol Lab Med 1987;111:373-4.
  • Ikeda K, Weir EC, Mangin M, Dannies PS, Kinder B, Deftos LJ, Brown EM, Broadus AE. Expression of messenger ribonucleic acids encoding a parathyroid hormone-like peptide in normal human and animal tissues with abnormal expression in human parathyroid adenomas. Mol Endocrinol 1988;2:1230-6.
  • Deftos LJ, Gazdar AF, Ikeda K, Broadus AE. The parathyroid hormone-related protein associated with malignancy is secreted by neuroendocrine tumors. Mol Endocrinol 1989;3:503-8.
  • Zabel M, Seidel J, Kaczmarek A, Surdyk-Zasada J, Grzeszkowiak J, Gorny A. Immunocytochemical characterization of two thyroid medullary carcinoma cell lines in vitro. Histochem J 1995;27:859-68.
  • Welbourn RB. Current status of the apudomas. Ann Surg 1977;185:1-12.
  • Deftos LJ, Parthemore JG. Secretion of parathyroid hormone in patients with medullary thyroid carcinoma. J Clin Invest 1974;54:416-20.
  • Markovitz M. Medullary carcinoma of the thyroid with hypercalcitoninemia and hypocalcemia. Ariz Med 1971;28:26-7.
  • Wysolmerski JJ, Vasavada R, Foley J, et al. Transactivation of the PTHrP gene in squamous carcinomas predicts the occurence of hypercalcemia in athymic mice. Cancer Res 1996;56:1043-9.
  • Corresponding Author: Dr. Kerem OKUTUR
  • Mazıdağı State Hospital,
  • Mazıdagi, Mardin 47770, Turkey. Phone : 505 7190165 Fax : 482 5111014
  • Email : keremokutur007@yahoo.com
Toplam 23 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Makaleler
Yazarlar

Kerem Okutur Bu kişi benim

Cemal Bes Bu kişi benim

Adile Çakır Bu kişi benim

Emrah Mazı Bu kişi benim

Guliz Dirimen Bu kişi benim

Engin Ciğercioğulları Bu kişi benim

Fatih Borlu Bu kişi benim

Yayımlanma Tarihi 1 Ağustos 2007
Yayımlandığı Sayı Yıl 2007 Cilt: 14 Sayı: 4

Kaynak Göster

APA Okutur, K., Bes, C., Çakır, A., Mazı, E., vd. (2007). Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu. Journal of Turgut Ozal Medical Center, 14(4), 263-266.
AMA Okutur K, Bes C, Çakır A, Mazı E, Dirimen G, Ciğercioğulları E, Borlu F. Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu. Turgut Özal Tıp Merk Derg. Ağustos 2007;14(4):263-266.
Chicago Okutur, Kerem, Cemal Bes, Adile Çakır, Emrah Mazı, Guliz Dirimen, Engin Ciğercioğulları, ve Fatih Borlu. “Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu”. Journal of Turgut Ozal Medical Center 14, sy. 4 (Ağustos 2007): 263-66.
EndNote Okutur K, Bes C, Çakır A, Mazı E, Dirimen G, Ciğercioğulları E, Borlu F (01 Ağustos 2007) Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu. Journal of Turgut Ozal Medical Center 14 4 263–266.
IEEE K. Okutur, “Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu”, Turgut Özal Tıp Merk Derg, c. 14, sy. 4, ss. 263–266, 2007.
ISNAD Okutur, Kerem vd. “Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu”. Journal of Turgut Ozal Medical Center 14/4 (Ağustos 2007), 263-266.
JAMA Okutur K, Bes C, Çakır A, Mazı E, Dirimen G, Ciğercioğulları E, Borlu F. Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu. Turgut Özal Tıp Merk Derg. 2007;14:263–266.
MLA Okutur, Kerem vd. “Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu”. Journal of Turgut Ozal Medical Center, c. 14, sy. 4, 2007, ss. 263-6.
Vancouver Okutur K, Bes C, Çakır A, Mazı E, Dirimen G, Ciğercioğulları E, Borlu F. Paratiroid Hormon İlişkili Proteine Bağlı Malin Hiperkalsemiyle Başvuran Meduller Tiroid Karsinomu Olgusu. Turgut Özal Tıp Merk Derg. 2007;14(4):263-6.