Hypercalcemia associated with adenosquamous pancreatic carcinoma: a reason to initiate palliative treatment

López-Tomassetti-Fernández, Eudaldo M.; Favre-Rizzo, Julian; Delgado‐Plasencia, Luciano; Hernández-Hernández, Juan Ramón

doi:10.4321/s1130-01082013000700009

Cited by 6 publications

(5 citation statements)

References 14 publications

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“…However, while lung cancer is commonly associated with hypercalcemia, brain, pancreatic and gastric cancers are less so. Nevertheless high calcium has been described in gastrointestinal pancreatic and brain cancer patients [29][30][31][32]. Only hepatocellular carcinoma (HCC) was more significant than MM after correction.…”

Section: Discussionmentioning

confidence: 99%

Hypercalcemia in Cancer: Association with Malignancy Type and Effect on Mortality

2016

JAPM

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Purpose Hypercalcemia is an electrolyte disorder found in cancer patients which can complicate the disease and hasten death. It is classified by a blood serum calcium level of 2.6 mmol/l and above and its incidence is related to malignancy type. The object of this study is to explore the distribution of hypercalcemia amongst different cancer forms and to record the effects on mortality. The study investigates the same factors with regards to moderate and severe hypercalcemia. Methods Medical records for 2048 patients admitted over a five year period (2008-12) to the National Centre for Cancer Care, Qatar, were retrospectively reviewed to establish calcium levels. Results Chi-square distinguished multiple myeloma, renal cell carcinoma and lung cancer as the most common malignancies associated with hypercalcemia in our sample. The malignancies that most commonly resulted in severe hypercalcemia were multiple myeloma, head and neck and renal cell carcinoma. Univariate analysis identified hypercalcemia, age, and gender and cancer type as predictive factors for survival over the period of the study. These factors were used to build a multivariate model which revealed cancer patients with hypercalcemia were three times more likely to die than patients with normal blood calcium levels. Expiry was also more probable in those above 65 years of age and unexpectedly, females. Another unanticipated finding was that the effects of moderate and severe hypercalcemia on mortality were similar. Conclusions The present study demonstrated that in a hospitalized cancer population, age, gender, cancer type, and hypercalcemia are prognostic factors for increased mortality. The marginal differences in mortality between those with moderate or severe hypercalcemia suggest that early detection and treatment of such electrolyte imbalance is warranted regardless of calcium severity.

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Section: Discussionmentioning

confidence: 99%

Hypercalcemia in Cancer: Association with Malignancy Type and Effect on Mortality

2016

JAPM

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“…Elevated levels of CA 19-9 and CEA are found in most patients [ 189 ]. Hypercalcemia of malignancy is found in some cases, probably related to high serum levels of parathyroid hormone-related protein [ 190 , 191 , 192 ].…”

Section: Malignant Lesions ( Table S3 )mentioning

confidence: 99%

Rare Solid Pancreatic Lesions on Cross-Sectional Imaging

Veron Sanchez,

Santamaria Guinea,

Cayon Somacarrera

et al. 2023

Diagnostics

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Several solid lesions can be found within the pancreas mainly arising from the exocrine and endocrine pancreatic tissue. Among all pancreatic malignancies, the most common subtype is pancreatic ductal adenocarcinoma (PDAC), to a point that pancreatic cancer and PDAC are used interchangeably. But, in addition to PDAC, and to the other most common and well-known solid lesions, either related to benign conditions, such as pancreatitis, or not so benign, such as pancreatic neuroendocrine neoplasms (pNENs), there are solid pancreatic lesions considered rare due to their low incidence. These lesions may originate from a cell line with a differentiation other than exocrine/endocrine, such as from the nerve sheath as for pancreatic schwannoma or from mesenchymal cells as for solitary fibrous tumour. These rare solid pancreatic lesions may show a behaviour that ranges in a benign to highly aggressive malignant spectrum. This review includes cases of an intrapancreatic accessory spleen, pancreatic tuberculosis, solid serous cystadenoma, solid pseudopapillary tumour, pancreatic schwannoma, purely intraductal neuroendocrine tumour, pancreatic fibrous solitary tumour, acinar cell carcinoma, undifferentiated carcinoma with osteoclastic-like giant cells, adenosquamous carcinoma, colloid carcinoma of the pancreas, primary leiomyosarcoma of the pancreas, primary and secondary pancreatic lymphoma and metastases within the pancreas. Therefore, it is important to determine the correct diagnosis to ensure optimal patient management. Because of their rarity, their existence is less well known and, when depicted, in most cases incidentally, the correct diagnosis remains challenging. However, there are some typical imaging features present on cross-sectional imaging modalities that, taken into account with the clinical and biological context, contribute substantially to achieve the correct diagnosis.

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“…Jaundice may be less prominent given that primary tumors in the head of the pancreas are less frequent than seen in PDAC, with a higher incidence of body and tail tumors observed. While malignant hypercalcemia is almost never seen in PDAC, multiple cases of hypercalcemia due to elevated PTHrP (Parathyroid hormone-related protein) have been reported in ASCP patients [ 97 – 99 ] . This is likely driven by the squamous component, given that malignant hypercalcemia is not infrequently seen in other squamous solid tumors that arise from lung, esophagus, and head and neck [ 100 ] .…”

Section: Adenosquamous Carcinoma Of the Pancreas (Ascp)mentioning

confidence: 99%

Two rare cancers of the exocrine pancreas: to treat or not to treat like ductal adenocarcinoma?

2023

J Cancer Metastasis Treat

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Pancreatic cancer is an aggressive malignancy with increasing incidence. Pancreatic ductal adenocarcinoma (PDAC) accounts for > 90% of pancreatic cancer diagnoses, while other exocrine tumors are much rarer. In this review, we have focused on two rare cancers of the exocrine pancreas: adenosquamous carcinoma of the pancreas (ASCP) and pancreatic acinar cell carcinoma (PACC). The latest findings regarding their cellular and molecular pathology, clinical characteristics, prognosis, and clinical management are discussed. New genetic and transcriptomic data suggest that ASCP is related to or overlaps with the basal transcriptomic subtype of PDAC. These tumors are highly aggressive and driven by activated KRAS and MYC expression. Clinical outcomes remain poor and effective treatments are limited. PACC has no morphologic or genetic resemblance to PDAC and more favorable outcomes. Early stage PACC patients have improved survival with surgical resection and patients with advanced disease benefit most from platinum-or fluoropyrimidine-containing chemotherapy. Frequency of actionable genetic mutations is high in this disease and case reports suggest good outcomes when matched therapy is given. Dedicated clinical studies examining ASCP and PACC are limited and difficult to accrue. Further research is needed to define optimal clinical management for these rare diseases.

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Hypercalcemia associated with adenosquamous pancreatic carcinoma: a reason to initiate palliative treatment

Cited by 6 publications

References 14 publications

Hypercalcemia in Cancer: Association with Malignancy Type and Effect on Mortality

Hypercalcemia in Cancer: Association with Malignancy Type and Effect on Mortality

Rare Solid Pancreatic Lesions on Cross-Sectional Imaging

Two rare cancers of the exocrine pancreas: to treat or not to treat like ductal adenocarcinoma?

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