Ben Said B, Maitre S, Perrot J-L, Labeille B, Cambazard F
Service de dermatologie, hôpital Nord, CHU St-Etienne, avenue Albert-Raimond, St-Priest-en-Jarez, France.
Rev Med Interne. 2010 Apr;31(4):309-11. doi: 10.1016/j.revmed.2009.08.004. Epub 2010 Feb 18.
We report two cases of hypercalcemia-hyperleucocytosis paraneoplastic syndrome complicating cutaneous squamous cell carcinoma.
The first patient, a 50-year-old man, suffering for hidradenitis suppurativa for the past 20 years, was admitted for squamous cell carcinoma. Laboratory findings showed marked hypercalcemia and hyperleucocytosis. PTHrP serum level was increased. Bone scintigraphy was normal. There was evidence of pulmonary metastasis. Despite treatment the patient died of agranulocytosis. The second patient was a 60-year-old man who presented with several months enlarging left axillary tumour. He has been treated by surgery for a squamous cell carcinoma of the left hand, 6 months ago. Serum calcium and white cell bloods count were elevated. The diagnosis of metastatic lymph node of cutaneous squamous cell carcinoma was confirmed. There was evidence of pulmonary metastasis. Despite chemotherapy the patient died rapidly.
Hypercalcemia-hyperleucocytosis paraneoplastic syndrome is rarely described during the course of cutaneous squamous cell carcinoma. This syndrome seems to be related to hormones or cytokines secretion by the neoplasic cells including PTHrP and G-CSF. Some authors ascribe it a poor prognostic significance.
我们报告两例并发皮肤鳞状细胞癌的高钙血症-高白细胞血症副肿瘤综合征病例。
首例患者为一名50岁男性，过去20年一直患有化脓性汗腺炎，因鳞状细胞癌入院。实验室检查结果显示明显的高钙血症和高白细胞血症。血清甲状旁腺激素相关蛋白（PTHrP）水平升高。骨闪烁显像正常。有肺转移的证据。尽管进行了治疗，患者仍死于粒细胞缺乏症。第二例患者是一名60岁男性，出现左侧腋窝肿物增大数月。6个月前他因左手鳞状细胞癌接受了手术治疗。血清钙和白细胞计数升高。皮肤鳞状细胞癌转移性淋巴结的诊断得到证实。有肺转移的证据。尽管进行了化疗，患者仍很快死亡。
高钙血症-高白细胞血症副肿瘤综合征在皮肤鳞状细胞癌病程中很少被描述。该综合征似乎与肿瘤细胞分泌的激素或细胞因子有关，包括PTHrP和粒细胞集落刺激因子（G-CSF）。一些作者认为它具有不良的预后意义。
