Hypercalcemia Associated with Extramammary Paget's Disease
| Autor: | Takenobu Yamamoto, Yumi Aoyama, Tetsuko Sato, Ryo Tanaka, Wataru Fujimoto, Nobuhiko Kamitani, Yoshihisa Wada |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
musculoskeletal diseases Pathology medicine.medical_specialty extramammary paget’s disease Case Report Malignancy Extramammary Paget's disease lcsh:RC254-282 03 medical and health sciences 0302 clinical medicine Elcatonin Scrotum medicine Parathyroid hormone-related protein Lymph node medicine.diagnostic_test business.industry medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens 030104 developmental biology Zoledronic acid medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Skin biopsy Hypercalcemia business hormones hormone substitutes and hormone antagonists Behavioral disturbance medicine.drug |
| Zdroj: | Case Reports in Oncology Case Reports in Oncology, Vol 13, Iss 3, Pp 1209-1214 (2020) |
| ISSN: | 1662-6575 |
| Popis: | Hypercalcemia of malignancy occurs in up to one third of patients at some point during the course of their advanced stage. The majority of them is caused by humoral hypercalcemia of malignancy due to systemic secretion of parathyroid hormone–related protein (PTHrP) by tumor cells. Extramammary Paget’s disease is a slow-growing cutaneous malignancy commonly limited to the epidermis of the anogenital region, but rarely becomes invasive and metastatic to distant sites. Herein, we report a 70-year-old male patient with metastatic extramammary Paget’s disease. He consulted our hospital with altered consciousness and tumor in his genital area. Physical examination revealed erythematous plaque with a tumor on the scrotum and perineum. It was diagnosed as extramammary Paget’s disease (multiple liver metastases and multiple lymph node metastases by skin biopsy and image examination). Increases in serum-corrected calcium and PTHrP-intact levels (15.3 mg/dL and 66.1 pg/L, respectively) were confirmed. PTHrP immunohistochemistry showed positive staining in the tumor cells. We diagnosed humoral hypercalcemia of malignancy. We treated hypercalcemia with saline, furosemide, zoledronic acid, and elcatonin. Regarding the local control of the tumor, 30 Gy/10 Fr electron beam therapy was performed. However, treatment with zoledronic acid was only temporally effective to correct hypercalcemia, and an increased serum calcium level developed again. Concurrently, the liver metastases were rapidly enlarged, and his general condition gradually deteriorated. The patient died on day 55. When patients with extramammary Paget’s disease show unconsciousness, serum calcium level should be measured and PTHrP-producing tumor distinguished. |
| Databáze: | OpenAIRE |
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