Complete Tumor Resection for a Hepatocellular Carcinoma Secreting Parathyroid Hormone-related Peptide
| Autor: | Eun Kyoung Kim, Yun Hyi Ku, Sang Beom Kim, Chul Ju Han, Jin Su Kim, Ki Chul Shin, Gil Tae Lee |
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| Rok vydání: | 2015 |
| Předmět: |
Male
endocrine system medicine.medical_specialty Carcinoma Hepatocellular Nausea medicine.medical_treatment Gastroenterology Metastasis Lethargy Internal medicine medicine Humans Aged Parathyroid hormone-related protein business.industry Liver Neoplasms Parathyroid Hormone-Related Protein Cancer General Medicine medicine.disease Magnetic Resonance Imaging digestive system diseases Surgery Positron-Emission Tomography Hepatocellular carcinoma Vomiting Cholecystectomy medicine.symptom Tomography X-Ray Computed business hormones hormone substitutes and hormone antagonists |
| Zdroj: | The Korean Journal of Gastroenterology. 66:122 |
| ISSN: | 2233-6869 1598-9992 |
| DOI: | 10.4166/kjg.2015.66.2.122 |
| Popis: | Hepatocellular carcinoma (HCC) is the fifth most common cancer in Korea. Diverse paraneoplastic syndromes can occur in patients with HCC, but parathyroid hormone-related peptide (PTH-rP)-induced hypercalcemia is uncommon. Hypercalcemia due to PTH or particularly PTH-rP-secreting HCC is associated with poor outcomes. We report a 71-year-old man who presented with symptoms of vague abdominal discomfort, somnolence, lethargy, nausea, vomiting, and weight loss. Imaging studies revealed a large HCC without metastasis. The laboratory findings showed elevated serum calcium level, low intact parathyroid hormone (iPTH) level and elevated PTH-rP level. These results led to a diagnosis of a PTH-rP-secreting HCC and paraneoplastic hypercalcemia. After emergency management of the hypercalcemia, the patient underwent an extended right hemihepatectomy with cholecystectomy. One year after the surgery, he is alive with normal calcium, PTH-rP, and iPTH levels. This case demonstrates that the rare phenomenon of life-threatening hypercalcemia caused by HCC should not be overlooked. These symptoms offer a good opportunity to diagnose HCC early. Radical tumor resection makes it possible to cure patients with PTH-rP-secreting HCC. |
| Databáze: | OpenAIRE |
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