Akoun G, Huchon G, Marsac J, Hasson I
Sem Hop. 1976 Feb 9;52(6):387-96.
Paraneoplastic hypercalcemia is frequently observed in squamous cell carcinoma of the bronchus. Clinically, apart from the general symptoms which are always very marked, neurological signs are the most common. This hypercalcemia, accompanied by hypophosphatemia, is of sudden onset and immediately very high. Metabolic alkalosis, with hypokalemia and hypochloremia, differentiates it from true hyperparathyroidism. Symptomatic treatment is only transiently effective. However, the obvious effect of mitramycin may be useful before surgical operation, which alone produces a lasting normalisation of serum calcium. Inappropriate secretion of a parathormone substance by the tumour may be demonstrated by radio-immunoassay, and this explains a large number of cases of hypercalcemia but this does not exclude other possible factors in the etiology. Finally, hypercalcemia originally attributed to bony lysis, may be explained in some cases by a paraneoplastic process.
副肿瘤性高钙血症常见于支气管鳞状细胞癌。临床上,除了通常非常明显的一般症状外,神经体征最为常见。这种伴有低磷血症的高钙血症起病突然且血钙水平立即很高。伴有低钾血症和低氯血症的代谢性碱中毒可将其与真正的甲状旁腺功能亢进相鉴别。对症治疗仅能暂时有效。然而,光辉霉素的明显疗效在手术前可能有用,只有手术才能使血清钙持久恢复正常。通过放射免疫测定可证实肿瘤分泌甲状旁腺素样物质不当,这解释了大量高钙血症病例,但这并不排除病因中其他可能的因素。最后,最初归因于骨质溶解的高钙血症,在某些情况下可能由副肿瘤过程来解释。