Hypercalcemia as Initial Presentation of Metastatic Adenocarcinoma of Gastric Origin: A Case Report and Review of the Literature

Hypercalcemia of malignancy due to metastatic gastric adenocarcinoma is extremely rare; in fact, to the best of our knowledge, only three case reports of hypercalcemia associated with metastatic gastric adenocarcinoma have been published in the literature to date. Herein, we report a rare case involving a 61-year-old African-American female who had hypercalcemia at initial presentation and who was later diagnosed with poorly differentiated gastric adenocarcinoma with extensive liver metastases, without bone involvement. She was found to have elevated parathyroid hormone-related peptide and normal parathyroid hormone levels. Despite aggressive treatment, she died within a few months of diagnosis.

A Case of Humoral Hypercalcemia of Malignancy Associated with Hepatoma: A Case in which both PTHrP and 1,25 (OH) 2D were elevated / 대한내분비학회지

Hypercalcemia is one of the most common paraneoplastic syndromes and believed to occur through two general mechanisms, one humoral and the other local. The former mechanism has been termed humoral hypercalcemia of malignancy (HHM) and has been associated with the secretion of various cytokines, including parathyroid hormone-related protein (PTHrP). PTHrP beats sttuctural and functional similarities to PTH and seems to play a key role in the pathogenesis of HHM. We experienced the case of HHM associated with hepatoma, a rare cause of HHM, in 48 year-old male. We found no evidence of bone metastasis. In this case, contrary to our general acknowledgment, serum 1,25 (OH)D concentration was elevated. We report this case with a brief review of related literatures.