Haimi Motti, Yang Ji Wei, Kremer Richard
Meuhedet Health Services, Northern District, Israel.
Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, 3109601, Haifa, Israel.
J Med Case Rep. 2025 Feb 10;19(1):54. doi: 10.1186/s13256-025-05074-9.
The parathyroid-hormone-related peptide has been shown in earlier studies to be secreted by pancreatic neuroendocrine tumors, although its secretion by gastroenteropancreatic neuroendocrine tumors is very rare. In contrast, a number of solid tumors, such as lung cancer and renal cell carcinoma, have frequently been shown to secrete parathyroid-hormone-related peptide.
We describe a case report of a 53-year-old Canadian white patient with refractory parathyroid-hormone-related-peptide-mediated hypercalcemia associated with metastatic pancreatic neuroendocrine tumors and review the available research. Our patient had severe hypercalcemia initially refractory to treatment. Computed tomography scan of the abdomen revealed a pancreatic lesion and multiple hepatic metastases. A liver biopsy confirmed metastatic pancreatic neuroendocrine tumor expressing parathyroid-hormone-related peptide. Circulating parathyroid-hormone-related peptide levels were at the upper limit of normal preoperatively and decreased sharply postoperatively following debulking of the tumor. Blood calcium levels eventually normalized on long-term administration of the somatostatin analog lanreotide in combination with denosumab.
We describe a case with parathyroid-hormone-related-peptide-mediated hypercalcemia in a pancreatic neuroendocrine tumor (parathyroid-hormone-related peptide tumor). Refractory hypercalcemia was likely the result of parathyroid-hormone-related peptide overproduction by the tumor and resolved following normalization of parathyroid-hormone-related peptide levels.
早期研究表明，甲状旁腺激素相关肽由胰腺神经内分泌肿瘤分泌，尽管胃肠胰神经内分泌肿瘤分泌该肽的情况极为罕见。相比之下，许多实体瘤，如肺癌和肾细胞癌，常被证明可分泌甲状旁腺激素相关肽。
我们描述了一例53岁加拿大白人患者，其患有与转移性胰腺神经内分泌肿瘤相关的难治性甲状旁腺激素相关肽介导的高钙血症，并回顾了现有研究。我们的患者最初患有严重的高钙血症，对治疗难治。腹部计算机断层扫描显示胰腺有病变和多处肝转移。肝活检证实为转移性胰腺神经内分泌肿瘤，表达甲状旁腺激素相关肽。术前循环中的甲状旁腺激素相关肽水平处于正常上限，肿瘤减瘤术后急剧下降。长期给予生长抑素类似物兰瑞肽联合地诺单抗后，血钙水平最终恢复正常。
我们描述了一例胰腺神经内分泌肿瘤（甲状旁腺激素相关肽肿瘤）中甲状旁腺激素相关肽介导的高钙血症病例。难治性高钙血症可能是肿瘤过度产生甲状旁腺激素相关肽的结果，在甲状旁腺激素相关肽水平恢复正常后得以解决。
