Hypercalcemia in small cell carcinoma of the pancreas

Abstract

Although small cell carcinoma of the lung has a high incidence of skeletal metastasis and is frequently associated with paraneoplastic syndromes, it is only rarely associated with hypercalcemia. Similarly, the more unusual small cell carcinoma of the pancreas has not been associated with hypercalcemia. The authors describe the first such patient with small cell carcinoma of the pancreas and hypercalcemia. Comprehensive metabolic measurements (fasting calcium excretion, renal phosphorus threshold, 1,25 dihydroxyvitamin D, 25 hydroxyvitamin D levels, nephrogenous cyclic AMP and immunoreactive PTH levels) suggest that although bone metastases were present, the hypercalcemia may have been caused in part by humoral mechanisms.

Small cell carcinoma of the pancreas: role of EUS-FNA and subsequent effective chemotherapy using carboplatin and etoposide

“…The average age of a patient at presentation is reportedly 60 years, with clinical symptoms of abdominal pain, weight loss, and/or jaundice. Hepatomegaly and ascites are also often present [5,[13][14][15][16][17][18][19][20][21]. Some SCCs are reportedly associated with endocrine symptoms, including Cushing-like syndrome [15], facial hirsutism [22], hypercalcemia [15], diabetes mellitus [6,23], and overexcretion/overproduction of 5-hydroxyindoleacetic acid [23] or adrenocorticotrophic hormone [17,22].…”

“…Due to the aggressive nature of SCCs of the pancreas, most patients are diagnosed at an advanced stage of disease, with an average life expectancy of up to 2 months for symptomatic patients who do not receive chemotherapy [3,15,16,19,20]. Thus, chemotherapy is the only available treatment option for those patients.…”

Nonductal neoplasms of the pancreas

“…4 They usually arise in adults 84 and there is a male predominance. 85 Some cases have associated paraneoplastic syndromes including Cushing's syndrome, 86 hypercalcemia, 87 and carcinoid syndrome. 16 In contrast to well-differentiated PENs, poorly differentiated endocrine carcinomas are highly aggressive, with early dissemination and a rapidly fatal course.…”

Practical Markers Used in the Diagnosis of Endocrine Tumors

“…70 Clinically hyperfunctioning hormonal syndromes are extremely rare in these poorly differentiated tumors, although rare cases of ACTH-producing tumors and tumors associated with hypercalcemia have been reported. [147][148][149][150] …”