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Hypercalcaemia in a patient with fatal adenosquamous carcinoma of the colon
Author(s) -
Links Matthew,
Ho Happy,
Clingan Phillip,
Diamond Terrance
Publication year - 1994
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1994.tb125834.x
Subject(s) - hypercalcaemia , medicine , adenosquamous carcinoma , malignancy , primary hyperparathyroidism , parathyroid hormone related protein , gastroenterology , metastatic carcinoma , pathology , colorectal cancer , carcinoma , cancer , parathyroid hormone , adenocarcinoma , calcium
Objective To report a rare manifestation of metastatic adenosquamous carcinoma of the colon in a patient presenting with humoral hypercalcaemia of malignancy mediated by parathyroid hormone related peptide (PTHrP). Clinical features A 58‐year‐old man with metastatic adenosquamous carcinoma of the colon presented with hypercalcaemia. A technetium bone scan excluded osteolytic bone secondaries. A negative parathyroid subtraction scan and a low serum immunoreactive parathyroid hormone level (1‐34 [amino acid fragment]) made the diagnosis of primary hyperparathyroidism unlikely. The diagnosis of humoral hypercalcaemia of malignancy was considered on the basis of an elevated serum PTHrP level and positive tumour immuno‐reactivity to PTHrP antiserum. Intervention and outcome The hypercalcaemia was effectively treated on two occasions with intravenous administration of amino‐hydroxy propilidene diphosphonate. Despite interventional chemotherapy, the patient died of progressive carcinomatosis. Conclusion Hypercalcaemia is an extremely rare occurrence in carcinoma of the colon. This is the first documented case of humoral hypercalcaemia of malignancy associated with adenosquamous carcinoma of the colon mediated by PTHrP.