Hypercalcemia Induced by Parathyroid Hormone-Related Peptide After Treatment of Carcinoma

Alina Gover, MD, P. Dileep Kumar, MD, Leon A. Brown, MD, Keyvan Ravakhah, MD

Disclosures

South Med J. 2002;95(2) 

In This Article

Abstract and Introduction

Squamous cell carcinoma of the head and neck is a rare cause of humoral hypercalcemia of malignancy. This paraneoplastic syndrome is usually one of the presenting symptoms of the disease. We report a case of squamous cell carcinoma of the oral cavity that presumably elaborated parathyroid hormone-related peptide (PTH-rP) and caused hypercalcemia only after radiotherapy and chemotherapy.

Hypercalcemia was recognized as the most common paraneoplastic syndrome as early as 1924.[1] Initial studies implicated parathyroid hormone in the development of hypercalcemia. The exact role of parathyroid hormone in the development of hypercalcemia of malignancy was questioned in the early 1970s.[2] The discovery of PTH-rP in 1987 by Mosley et al[3] evoked interest in the mechanisms by which certain cancers cause hypercalcemia without necessarily metastasizing to the bone. Hypercalcemia of malignancy is thought to be due to the PTH-rP elaborated by the tumor cells in the advanced stage of the disease. We report a case of squamous cell carcinoma of the oral cavity that elaborated PTH-rP and caused hypercalcemia only after radiotherapy and chemotherapy.

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