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It is known that high levels of parathyroid hormone-related protein (PTHrP) correlate with a bad prognostic in malignancies. Here we present a patient with advanced penile cancer (PC) without antecedents of human papillomavirus infections and bone metastases but with severe hypercalcemia. By quantitative polymerase chain reaction, we observed high levels of PTHrP messenger RNA in metastatic cutaneous tissue. This is the first reported case in Argentina of hypercalcemia induced by PTHrP in human PC. Furthermore, the association of PTHrP and this disease through quantitative polymerase chain reaction allows us to consider this molecular technique as a novel tool for diagnosis in patients with PC.

Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): University of Buenos Aires Background Cortisol is a stress marker in patients with acute coronary syndrome (ACS) and it has a permissive effect on the actions of hormones that increase glucose production. Its association with blood glucose levels in diabetic and non-diabetic patients could help to understand the relationship between stress, hyperglycaemia and mortality. Methods Prospective and observational single-centre study. All patients admitted with a diagnosis of ACS to the coronary care unit of a University Hospital were included. The age, sex and clinical characteristics were recorded, along with the clinical outcomes. On admission, blood samples were obtained to measure serum glucose (SG) and cortisol (SC). Results Over a total of 149 patients, 35.37% had a diagnosis of ST-segment elevation ACS. Median age was 69 (60.1 – 79) years, 61.1% were male, 59.5% were hypertense, 18.2% dyslipidemic, 23% smokers, and 28.4% diabetics. Total mortality during hospitalization was 6.8%, and cardiovascular mortality was 6.1%. We observed a significantly higher SC and SG on admission in patients who died (table 1), with a mild and positive correlation between them (Spearman’s rho = 0.24, p = 0.005). Diabetic patients had a higher SG on admission [191.1 mg/dl (157.5 – 250,8) vs. 116.0 mg/dl (99.0 – 141.0), < 0.001]. Diabetes was not associated with mortality, although correlation between glucose and cortisol remained constant in diabetics and non-diabetics (figure 1). Conclusion Hypercortisolemia and hyperglycaemia were associated with an increased in-hospital mortality. Although hyperglycemia confers a worse prognosis, we found that its correlation with cortisol was constant in diabetics and non-diabetics. This suggests that hyperglycaemia could be a surrogate stress marker, not related to diabetes as a risk factor in an acute setting. Serum glucose and cortisol on admission LaboratorySurvivorsNon-survivorsp-valueGlucose (mg/dL)128 (101 - 163)156 (134.5 - 197.2)0.04Cortisol (ug/dL)13.7 (7,98 - 23.65)43.7 (34.6 - 50.0)0.0004Abstract Figure. Serum cortisol and glucose on admission.