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.

A Case of Mediastinal Cystic Parathyroid Adenoma Presenting as Acute Pancreatitis / 대한내분비학회지

Hypercalcemia due to hyperparathyroidism is rarely associated with acute pancreatitis. But, the relationship between hypercalcemia and pancreatitis still remains controvesial. Ectopic parathyroid adenoma with cystic change is one of the rare causes of hyperparathyroidism, and is usually located in neck and mediastinum. We report a case of mediastinal parathyroid adenoma with cystic change associated with acute pancreatitis. A 54-year-old male presented with epigastric pain for 3 days. The serum calcium, phosphate, elastase were 16.8mg/dL, 1.1 mg/dL, 2772.0 ng/mL respectively and his parathyroid hormone level in serum was 651.84 pg/mL. Chest CT showed a mediastinal mass with well defined inhomogenously enhanced density located between SVC and aorta. The patient was diagnosed to hyperparathyroidism with acute pancreatitis due to mediastinal parathyroid adenoma with cystic change, and was surgically removed. The surgical biopsy showed parathyroid adenoma with cystic change. After operation his general condition was improved and serum calcium, phosphate, amylase, lipase level were normalized.