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Adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM). 2008
Noritoshi Kobayashi, and
Takuma Higurashi, and
Hiroshi Iida, and
Hironori Mawatari, and
Hiroki Endo, and
Yuichi Nozaki, and
Ayako Tomimoto, and
Kyoko Yoneda, and
Tomoyuki Akiyama, and
Koji Fujita, and
Hirokazu Takahashi, and
Masato Yoneda, and
Masahiko Inamori, and
Yasunobu Abe, and
Hiroyuki Kirikoshi, and
Kensuke Kubota, and
Satoru Saito, and
Norio Ueno, and
Atsushi Nakajima, and
Shoji Yamanaka, and
Yoshiaki Inayama
Department of Gastroenterology, Yokohama City University School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Japan.
We report a rare case of adenosquamous carcinoma of the pancreas associated with humoral hypercalcemia of malignancy (HHM) in which parathyroid hormone-related protein (PTH-rP) was identified as the causative factor of hypercalcemia. A 72-year-old Japanese man was admitted to our institution complaining of fever and abdominal pain. Abdominal computed tomography demonstrated a large tumor in the body of the pancreas, with multiple liver metastases. Both serum calcium and PTH-rP levels were elevated. No accumulation was observed on bone scan with technetium-99. The patient died of pneumonia 3 months after admission. Autopsy demonstrated that the neoplasm in the pancreas showed an abrupt histological transition from adenocarcinoma to squamous cell carcinoma. PTH-rP was identified in the primary pancreatic tumor cells by immunohistochemical examination and a reverse-transcription polymerase chain reaction (RTPCR) method. We concluded that PTH-rP was the causative factor of the HHM, based on the laboratory data, immunohistochemical examination, and messenger RNA (mRNA) expression. This is a very rare report of adenosquamous cell carcinoma of the pancreas associated with HHM.
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