A Case Report of Esophageal Carcinoma That Produced Parathyroid Hormone Related Protein (PTHrP) and G-CSF and Manifested Hypercalcemia and Leukocytosis

Esophageal carcinoma with humoral hypercalcemia and leukocytosis successfully treated by a two-stage operation: report of a case

“…Another possible reason for the successful outcome in this case was the fact that the patient was almost completely free from any typical symptoms of hypercalcemia. Because impaired general condition in patients with esophageal carcinoma with hypercalcemia and leukocytosis has been reported to be mainly caused by hypercalcemia [3][4][5][6][7][8], the absence of such symptoms of hypercalcemia in our case is thus considered to have played a major role in the patient's relatively good preoperative condition. Even though such a patient suffers from esophageal carcinoma with humoral hypercalcemia and leukocytosis but without a giant metastatic lesion, it might be better to consider a two-stage operation, consisting of a curative resection in the first stage and a subsequent reconstruction procedure in the second stage, to reduce the risk of postoperative complications.…”

“…Esophageal carcinoma complicated with both hypercalcemia and leukocytosis is very rare, and to our knowledge, there have been only six such reported cases to date (Table 1) [3][4][5][6][7][8], five of whom were Japanese patients. The majority of such patients tend to demonstrate an advanced stage of cancer, impaired general condition, and a poor prognosis.…”

“…The simultaneous production of PTHrP and G-CSF in esophageal carcinoma is very rare, and only six such cases have been reported to date [3][4][5][6][7][8]. Most cases of esophageal carcinoma with hypercalcemia and leukocytosis show severe inflammatory response, rapid tumor growth, poor general condition, and resistance to chemotherapeutic drugs.…”