成纤维黏液样肉瘤伴 PTHrP 分泌致高钙血症 1 例：对糖皮质激素治疗有反应
A Case of Hypercalcemia from PTHrP-Producing Fibromyxoid Sarcoma Responsive to Glucocorticoid Therapy.
机构信息
Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of California, San Francisco, 400 Parnassus Ave., Suite A-550, San Francisco, CA, 94143, USA.
Division of Endocrinology and Metabolism, Department of Medicine, Yale School of Medicine, Yale University, TAC S141D, 300 Cedar Street, New Haven, CT, 06520-8020, USA.
出版信息
Calcif Tissue Int. 2023 Aug;113(2):246-253. doi: 10.1007/s00223-023-01099-8. Epub 2023 Jun 26.
The treatment of parathyroid hormone-related protein (PTHrP)-mediated hypercalcemia of malignancy includes treating the malignancy, intravenous fluids, and anti-resorptive therapies such as zoledronic acid or denosumab. PTHrP-mediated hypercalcemia has been reported in benign conditions such as systemic lupus erythematous (SLE) and sarcoidosis and appears to be responsive to glucocorticoids. We report a case of PTHrP-induced hypercalcemia due to a malignancy-low grade fibromyxoid sarcoma-that responded to glucocorticoid treatment. This is the first report of glucocorticoids controlling PTHrP-mediated hypercalcemia of malignancy. Immunohistochemistry of the surgical pathology localized PTHrP staining to the vascular endothelial cells within the tumor. Further studies are needed to elucidate the mechanism of glucocorticoid action in the treatment of PTHrP-mediated hypercalcemia of malignancy.
甲状旁腺激素相关蛋白 (PTHrP) 介导的恶性肿瘤相关高钙血症的治疗包括治疗恶性肿瘤、静脉补液以及抗吸收治疗，如唑来膦酸或地舒单抗。良性疾病如系统性红斑狼疮 (SLE) 和结节病也有报道存在 PTHrP 介导的高钙血症，似乎对糖皮质激素敏感。我们报告了一例由低度纤维黏液样肉瘤引起的 PTHrP 诱导的高钙血症，该肿瘤对糖皮质激素治疗有反应。这是首例报道糖皮质激素控制 PTHrP 介导的恶性肿瘤相关高钙血症的病例。手术病理的免疫组化将 PTHrP 染色定位于肿瘤内的血管内皮细胞。需要进一步的研究来阐明糖皮质激素在治疗 PTHrP 介导的恶性肿瘤相关高钙血症中的作用机制。
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