Sakata Jun, Wakai Toshifumi, Shirai Yoshio, Sakata Eiko, Hasegawa Go, Hatakeyama Katsuyoshi
Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata 951-8510, Japan.
Surg Today. 2005;35(8):692-5. doi: 10.1007/s00595-004-2974-3.
Humoral hypercalcemia can arise from a variety of malignancies, but its association with primary colorectal carcinoma is rare, with only 20 such cases documented in the English-language literature to date. We report an additional case to clarify the clinicopathologic features of colorectal carcinoma with humoral hypercalcemia. A 54-year-old woman was admitted with symptomatic hypercalcemia of 14.2 mg/dl and multiple hepatic metastases, 2 years after resection of sigmoid colon cancer. The hypercalcemia was caused by the circulating parathyroid hormone-related peptide (PTHrP) produced by poorly differentiated adenocarcinoma in the liver. The PTHrP level on admission was 13.5 pmol/l. Despite systemic chemotherapy, the patient died of disease progression 3 weeks after the humoral hypercalcemia was diagnosed. A review of the 21 reported cases, including ours, suggests that colorectal carcinoma associated with humoral hypercalcemia is characterized by a poorly differentiated tumor with or without squamous or neuroendocrine features, distant metastases, and a dismal prognosis.
体液性高钙血症可由多种恶性肿瘤引起，但其与原发性结直肠癌的关联较为罕见，迄今为止英文文献中仅记载了20例此类病例。我们报告另外1例病例，以阐明伴有体液性高钙血症的结直肠癌的临床病理特征。一名54岁女性在乙状结肠癌切除术后2年，因14.2mg/dl的症状性高钙血症及多发肝转移入院。高钙血症由肝脏中低分化腺癌产生的循环甲状旁腺激素相关肽（PTHrP）引起。入院时PTHrP水平为13.5pmol/l。尽管进行了全身化疗，但患者在体液性高钙血症被诊断后3周因疾病进展死亡。对包括我们的病例在内的21例报告病例的回顾表明，与体液性高钙血症相关的结直肠癌的特征为具有或不具有鳞状或神经内分泌特征的低分化肿瘤、远处转移及预后不良。
