Iqbal Iqra, Khan Muhammad Atique Alam, Khan Yasir, Thalambedu Nishanth, Munir Samavia
Internal Medicine, Abington Hospital - Jefferson Health, Abington, USA.
Cureus. 2019 Nov 8;11(11):e6097. doi: 10.7759/cureus.6097.
Humoral hypercalcemia of malignancy (HHM) can be caused by ectopic paraneoplastic production of 1, 25 dihydroxy vitamin D due to the hyperactivity of the 1 alpha-hydroxylase enzyme. We present a case of a 19-year-old female who was admitted with bilateral dysgerminomas and significant hypercalcemia. Hypercalcemia was initially managed medically and then resolved with the surgical resection of the tumors. Although most cases are attributed to a high parathyroid hormone-related peptide (PTHrP) and bone metastases, <1% of cases can result from paraneoplastic production of 1,25 dihydroxyvitamin D due to increased activity of 1 alpha-hydroxylase.This is one of the rare cases of hypercalcemia, which not only adds to the limited number of cases of hypercalcemia associated with dysgerminoma but also is the first case report showing that vitamin D can be a paraneoplastic factor itself.
恶性肿瘤体液性高钙血症（HHM）可由1α-羟化酶活性过高导致异位副肿瘤性产生1,25-二羟维生素D引起。我们报告一例19岁女性患者，因双侧无性细胞瘤和显著高钙血症入院。高钙血症最初采用药物治疗，随后通过手术切除肿瘤得以缓解。尽管大多数病例归因于高甲状旁腺激素相关肽（PTHrP）和骨转移，但<1%的病例可由1α-羟化酶活性增加导致副肿瘤性产生1,25-二羟维生素D引起。这是高钙血症的罕见病例之一，不仅增加了与无性细胞瘤相关的高钙血症病例数量，也是首例表明维生素D本身可作为副肿瘤因素的病例报告。
