Tsunematsu R, Saito T, Iguchi H, Fukuda T, Tsukamoto N
Gynecology Service, Department of Biochemistry, Department of Pathology, National Kyushu Cancer Center, Notame 3-1-1, Minami-ku, Fukuoka, 811-1395, Japan.
Gynecol Oncol. 2000 Feb;76(2):218-22. doi: 10.1006/gyno.1999.5619.
Amongovarian carcinomas, clear cell adenocarcinoma is one of the most common histologic subtypes associated with hypercalcemia. However, the mechanisms of hypercalcemia in clear cell adenocarcinoma are still unclear. In the following case report, we tried to determine the etiology of hypercalcemia and also to demonstrate the management of hypercalcemia diagnosed preoperatively.
A 49-year-old woman was diagnosed as having a malignant ovarian tumor with hypercalcemia caused by elevated serum parathyroid hormone-related protein (PTHrP) prior to her primary surgery. Treatment with disodium incadronate promptly normalized the serum calcium level. An immunohistochemical study demonstrated PTHrP expression in the primary ovarian lesion, but not in the metastatic lesion. A Northern blot analysis of the cancer cells from the ovarian tumor confirmed the presence of PTHrP mRNA.
Humoral hypercalcemia of malignancy in this case has been conclusively shown to be due to the production of PTHrP at the primary ovarian tumor, based on both immunohistochemical and molecular analyses.
在卵巢癌中，透明细胞腺癌是与高钙血症相关的最常见组织学亚型之一。然而，透明细胞腺癌中高钙血症的机制仍不清楚。在以下病例报告中，我们试图确定高钙血症的病因，并展示术前诊断的高钙血症的管理方法。
一名49岁女性在初次手术前被诊断为患有恶性卵巢肿瘤并伴有高钙血症，血清甲状旁腺激素相关蛋白（PTHrP）升高所致。因卡膦酸二钠治疗迅速使血清钙水平恢复正常。免疫组织化学研究显示原发性卵巢病变中有PTHrP表达，但转移病变中没有。对卵巢肿瘤癌细胞的Northern印迹分析证实存在PTHrP mRNA。
基于免疫组织化学和分子分析，该病例中的恶性肿瘤体液性高钙血症已确凿地表明是由于原发性卵巢肿瘤产生PTHrP所致。
