PTHrP-producing Tumor: Squamous Cell Carcinoma of the Liver Accompanied by Humoral Hypercalcemia of Malignancy, Increased IL-6 and Leukocytosis.

Asanuma, Nobuyuki; Hagiwara, Keisuke; Matsumoto, Ikuko; Matsuda, Masahiro; Nakamura, Fumiaki; Kouhara, Haruhiko; Miyamoto, Makoto; Miyashita, Yoshihiro; Noguchi, Sanai; Morimoto, Yoshihiro

doi:10.2169/internalmedicine.41.371

Cited by 15 publications

(7 citation statements)

References 25 publications

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“…Recent studies have suggested that some inflammatory cytokines, including IL-6, may be associated with G-CSF production by malignant cells [ 26 ]. Moreover, hypercalcemia has been associated with cosecretion of PTHrP and IL-6 [ 27 ]. We previously showed that increased IL-6 expression in cancer cells predicted a poor response to chemoradiotherapy and an unfavorable prognosis in patients with oral SCC [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review

et al. 2016

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BackgroundParaneoplastic syndrome generally results from tumor-derived hormones or peptides that cause metabolic derangements. Common metabolic conditions include hyponatremia, hypercalcemia, hypoglycemia, and Cushing’s syndrome. Herein, we report a very rare case of tongue carcinoma presenting with leukocytosis and hypercalcemia.Case presentationA 57-year-old man was admitted to our hospital with tongue squamous cell carcinoma (cT4aN0M0, stage IV). He underwent radical resection following preoperative chemoradiotherapy, but locoregional recurrence was detected 2 months after surgery. He presented with marked leukocytosis and hypercalcemia with elevated serum levels of granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP). He was therefore managed with intravenous fluids, furosemide, prednisolone, elcatonin, and pamidronate. However, the patient died 1 month later of carcinomatous pleuritis following distant metastasis to the lung. Immunohistochemical analyses of the resected specimens revealed positive staining for PTHrP and G-CSF in the cancer cells.ConclusionsIn this case, it was considered that tumor-derived G-CSF and PTHrP caused leukocytosis and hypercalcemia.

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Section: Discussionmentioning

confidence: 99%

Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review

et al. 2016

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“…On the other hand, it was reported that IL-6 caused leukocytosis related to several malignancies. Leukocytosis is considered the result of elevated IL-6 in connection with parathyroid hormone-related protein secreted primary tumor or with necrotic tissue involved tumor cells (23). It is probable that these humoral factors were partially responsible for the paraneoplastic syndromes induced by the prostate cancer with bone marrow metastasis in the present case.…”

Section: Discussionmentioning

confidence: 77%

Leukemoid Reaction in Association with Bone Marrow Necrosis due to Metastatic Prostate Cancer

et al. 2005

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An 80-year-old man presented to the internist with fever, fatigue and leukocytosis up to 66.8×10 3 / l. Although a chronic myelogenous leukemia was initially suspected, he was diagnosed as metastatic bone marrow tumor with bone marrow necrosis from primary prostate cancer on the basis of the clinical and pathological findings. The serum concentrations of IL-6 and TNF-were mildly elevated to 65.0 pg/ml and, 54.0 pg/ml respectively. It is probable that these humoral factors were partially responsible for the leukemoid reaction although other factors induced by the bone marrow necrosis with bone marrow metastasis of prostate cancer are also likely involved. (Internal Medicine 44: 1093-1096, 2005)

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“…This is caused by cancer cells producing PTH-rP with an almost identical structure to PTH, which is therefore able to bind bone and renal PTH-1 receptors. This enhances renal reabsorption and osseous release of calcium [10,11]. Besides the hypercalcaemia, PTH-rP might also be responsible for the leukocytosis and thrombocytosis.…”

Section: Discussionmentioning

confidence: 99%

A paraplegic patient with fever and leucocytosis: not always what it seems

et al. 2019

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A 54-year-old obese woman with a history of spina bifida was admitted to the hospital with malaise and fever accompanied by leucocytosis, thrombocytosis, and hypercalcaemia. As treatment for neurogenic bladder dysfunction she had a suprapubic catheter. Diagnostic workup for osteomyelitis revealed an unknown mass originating from the urinary bladder on MRI of the pelvis. Further diagnostic analyses showed that the mass was a squamous-cell carcinoma (SCC) with laboratory abnormalities as paraneoplastic phenomena mediated by PTH-related peptide and cytokines released by the SCC. Despite radiotherapy the patient died within two months after initial diagnosis.Squamous-cell carcinoma of the bladder is rare in western countries. In unresectable or metastatic disease survival rates are low due to low responsiveness to standard chemotherapy. Concurrent chemoradiotherapy might be an alternative in unresectable or locally advanced disease; however, evidence to support this is lacking. The poor survival in these patients raises the question of whether high-risk groups for SCC of the bladder, like paraplegic patients or patient with neurogenic bladder dysfunction, should receive screening even though the ideal starting point and frequency are still unknown.

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PTHrP-producing Tumor: Squamous Cell Carcinoma of the Liver Accompanied by Humoral Hypercalcemia of Malignancy, Increased IL-6 and Leukocytosis.

Cited by 15 publications

References 25 publications

Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review

Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review

Leukemoid Reaction in Association with Bone Marrow Necrosis due to Metastatic Prostate Cancer

A paraplegic patient with fever and leucocytosis: not always what it seems

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