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Adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM)
Author(s) -
Kobayashi Noritoshi,
Higurashi Takuma,
Iida Hiroshi,
Mawatari Hironori,
Endo Hiroki,
Nozaki Yuichi,
Tomimoto Ayako,
Yoneda Kyoko,
Akiyama Tomoyuki,
Fujita Koji,
Takahashi Hirokazu,
Yoneda Masato,
Inamori Masahiko,
Abe Yasunobu,
Kirikoshi Hiroyuki,
Kubota Kensuke,
Saito Satoru,
Ueno Norio,
Nakajima Atsushi,
Yamanaka Shoji,
Inayama Yoshiaki
Publication year - 2008
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-007-1258-x
Subject(s) - pancreas , malignancy , adenosquamous carcinoma , medicine , pathology , adenocarcinoma , immunohistochemistry , carcinoma , parathyroid hormone related protein , parathyroid hormone , cancer , calcium
We report a rare case of adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM) in which parathyroid hormone‐related protein (PTH‐rP) was identified as the causative factor of hypercalcemia. A 72‐year‐old Japanese man was admitted to our institution complaining of fever and abdominal pain. Abdominal computed tomography demonstrated a large tumor in the body of the pancreas, with multiple liver metastases. Both serum calcium and PTH‐rP levels were elevated. No accumulation was observed on bone scan with technetium‐99. The patient died of pneumonia 3 months after admission. Autopsy demonstrated that the neoplasm in the pancreas showed an abrupt histological transition from adenocarcinoma to squamous cell carcinoma. PTH‐rP was identified in the primary pancreatic tumor cells by immunohistochemical examination and a reverse‐transcription polymerase chain reaction (RTPCR) method. We concluded that PTH‐rP was the causative factor of the HHM, based on the laboratory data, immunohistochemical examination, and messenger RNA (mRNA) expression. This is a very rare report of adenosquamous cell carcinoma of the pancreas associated with HHM.