Hypercalcemia associated with lymph node metastasis following radical cystectomy for bladder cancer

Abstract

Introduction A part of hypercalcemia is a paraneoplastic syndrome. Its association with lymph node metastasis of bladder cancer has been infrequently reported in the literature. Case presentation A 75‐year‐old male presented with gross hematuria and was diagnosed with bladder cancer without metastasis. Following neoadjuvant chemotherapy, radical cystectomy was performed. The surgical margin was negative. The bladder cancer was classified as pT3bN0 and mainly constituted squamous differentiated urothelial carcinoma and sarcomatoid variant. His perioperative serum calcium levels were normal. At 6 months of surgery, computed tomography revealed lymph node enlargement, and additional 2 weeks later, he developed epileptic seizures with a serum corrected calcium level of 18.7 mg/dL. He was diagnosed with hypercalcemia caused by the lymph node metastasis of bladder cancer. Despite receiving several supportive therapies for 22 days, he died. Conclusion Hypercalcemia associated with bladder cancer is highly resistant to existing therapy, particularly when caused by cancer metastasis.

Hypercalcemia–leukocytosis syndrome from non-schistosomiasis-associated squamous cell carcinoma of the urinary bladder: a case report and review of the literature

“…Hypercalcemia manifests with lethargy, gastrointestinal symptoms, bone and abdominal pains, and increased mortality, neurologic, renal, and/or cardiac impairment in severe cases [ 20 ]. Conservative care includes hydration, loop diuretics, bisphosphonates [ 6 ], denosumab, mithracin, hemodialysis, calcitonin, and glucocorticoids [ 21 ].…”

“…Conservative care includes hydration, loop diuretics, bisphosphonates [ 6 ], denosumab, mithracin, hemodialysis, calcitonin, and glucocorticoids [ 21 ]. Persistent hypercalcemia after extirpative surgery and/or adjuvant therapy for predominant SCC is a marker of recurrence [ 20 ].…”

Роль Паратгормон-Родственного Протеина В Развитии, Функционировании И Патологии Мочевыделительной И Репродуктивной Систем

“…Инфузия диуретиков, кальцитонина и динатрий памидроната для лечения гиперкальциемии оказались малоэффективными(Akashi T. et al, 1999). В недавней публикацииAndo T. et al (2018) сообщили о случае высоко резистентной к существующей терапии тяжелой гиперкальциеми, связанной с метастазами в лимфатические узлы после радикальной цистэктомии при раке мочевого пузыря.В научной литературе представлены очень интересные данные о случаях рака мочевого пузыря с одновременной продукцией ПТГрП и гранулоцитарного колониестимулирующего фактора (G-CSF), который стимулирует рост и дифференцировку нейтрофильных гранулоцитов, что приводит к выраженному лейкоцитозу без какой-либо инфекции. Лейкемоидные реакции и гиперкальциемия являются распространенными признаками малигнизации.…”