Retroperitoneal neurilemoma presenting with humoral hypercalcemia associated with markedly elevated plasma prostaglandin levels
✍ Scribed by Itaru Komiya; Ken Yamaguchi; Yoshio Miyake; Satoshi Honda; Takayuki Tsuchihashi; Toru Shimizu; Noriko Fukushima; Yasuhiro Saito
- Publisher
- John Wiley and Sons
- Year
- 1991
- Tongue
- English
- Weight
- 624 KB
- Volume
- 68
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
A 72-year-old woman complaining of somnolence and thirst was diagnosed to have a hypercalcemic crisis (corrected serum calcium level, 17.4 mg/dl) associated with encephalopathy and nephropathy. Imaging diagnostic techniques demonstrated a retroperitoneal tumor at the median site of right renal pelvis. Hormonal studies revealed that plasma levels of thromboxane B,, prostaglandin (PG) E2, 6-keto prostaglandin F1, (PGF,,) and prostaglandin F2, (PGF,,) were markedly elevated. The tumor was successfully removed by operation; her serum calcium level and PG levels normalized without any treatment indicating that this case belongs to the category of humoral hypercalcemia of malignancy (HHM). Pathologically, this tumor was diagnosed to be a benign neurilemoma. Parathyroid hormone-related protein (PTHrP) radioimmunoassay and Northern blot hybridization for PTHrP mRNA were negative. The current case demonstrates that hypercalcemic crisis could be induced by a curable benign neurilemoma, and suggests that this HHMlike morbidity was associated with markedly elevated plasma PG levels. Cancer 68:1086-1091.1991.
YPERCALCEMIA is one of the most frequent paraneoplastic syndromes that develops in cancer patients. ' This cancer-associated electrolyte imbalance is caused by two different mechanism^.^,^ One mechanism is associated with extensive bone metastases, and the other is induced by the production of hypercalcemic factors by