A Case of Parathyroid Hormone-related Protein Producing Tumor in Simultaneous Multiple Cancers of the Breast and Lung

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  • 乳癌・原発性肺腺癌の同時性重複癌におけるPTHrP産生腫瘍の1例
  • ニュウガン ・ ゲンパツセイ ハイ センガン ノ ドウジセイ チョウフクガン ニ オケル PTHrP サンセイ シュヨウ ノ 1レイ

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Abstract

<p>The patient was a 69-year-old woman presented with general fatigue. She was referred to our hospital for examination and treatment of hypercalcemia and multiple liver masses. Her initial blood test revealed high Ca level of 16.9 mg/dL, high PTHrP of 56.0 pmol/L, low intact PTH of 9 pg/mL, elevated CEA of 1,305.1 ng/mL, and elevated CA15-3 of 154.0 U/mL. FDG-PET/CT showed FDG uptake in the right breast, left upper lung lobe, liver, axillary and supraclavicular lymph nodes, sternum, and L4 vertebra. Following a biopsy, she was diagnosed with right breast cancer cStage IV (pleura, liver, bone) and primary lung adenocarcinoma cStage I A3. There was no evidence of bone destruction but tumor cells of the breast and lung were positive for PTHrP in immunohistochemistry, indicating that the hypercalcemia was caused by PTHrP-producing tumors. PTHrP-producing tumors in patients with concomitant overlapping breast cancer and primary lung adenocarcinoma are rare, and we report this case with a review of the literature.</p>

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