Kaneko Naoki, Kawano Shintaro, Matsubara Ryota, Goto Yuichi, Jinno Teppei, Maruse Yasuyuki, Sakamoto Taiki, Hashiguchi Yuma, Iida Masakazu, Nakamura Seiji
Section of Oral and Maxillofacial Oncology, Division of Maxillofacial Diagnostic and Surgical Sciences, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Maxillofacial Diagnostic and Surgical Science, Department of Oral and Maxillofacial Rehabilitation, Course for Developmental Therapeutics, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
World J Surg Oncol. 2016 Jun 17;14(1):161. doi: 10.1186/s12957-016-0918-1.
Paraneoplastic syndrome generally results from tumor-derived hormones or peptides that cause metabolic derangements. Common metabolic conditions include hyponatremia, hypercalcemia, hypoglycemia, and Cushing's syndrome. Herein, we report a very rare case of tongue carcinoma presenting with leukocytosis and hypercalcemia.
A 57-year-old man was admitted to our hospital with tongue squamous cell carcinoma (cT4aN0M0, stage IV). He underwent radical resection following preoperative chemoradiotherapy, but locoregional recurrence was detected 2 months after surgery. He presented with marked leukocytosis and hypercalcemia with elevated serum levels of granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP). He was therefore managed with intravenous fluids, furosemide, prednisolone, elcatonin, and pamidronate. However, the patient died 1 month later of carcinomatous pleuritis following distant metastasis to the lung. Immunohistochemical analyses of the resected specimens revealed positive staining for PTHrP and G-CSF in the cancer cells.
In this case, it was considered that tumor-derived G-CSF and PTHrP caused leukocytosis and hypercalcemia.
副肿瘤综合征通常由肿瘤衍生的激素或肽引起代谢紊乱所致。常见的代谢状况包括低钠血症、高钙血症、低血糖症和库欣综合征。在此，我们报告一例非常罕见的舌癌病例，该病例表现为白细胞增多和高钙血症。
一名57岁男性因舌鳞状细胞癌（cT4aN0M0，IV期）入住我院。他在术前放化疗后接受了根治性切除术，但术后2个月检测到局部区域复发。他出现明显的白细胞增多和高钙血症，血清粒细胞集落刺激因子（G-CSF）和甲状旁腺激素相关蛋白（PTHrP）水平升高。因此，对他进行了静脉补液、呋塞米、泼尼松龙、降钙素和帕米膦酸治疗。然而，患者1个月后因肺癌远处转移导致癌性胸膜炎死亡。对切除标本的免疫组织化学分析显示癌细胞中PTHrP和G-CSF染色呈阳性。
在本病例中，认为肿瘤衍生的G-CSF和PTHrP导致了白细胞增多和高钙血症。
