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Intact PTH-producing hepatocellular carcinoma treated by transcatheter arterial embolization
Y Koyama1, H Ishijima, A Ishibashi
1Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Hospital, 3-39-22, Shouwa-machi Maebashi, Gunma, Japan.
Abdominal Imaging
|February 19, 1999
Summary
Hepatocellular carcinoma can cause hypercalcemia by producing intact parathyroid hormone (PTH). Transcatheter arterial chemoembolization successfully managed this rare complication, highlighting a novel treatment approach for cancer-related high calcium levels.
Area of Science:
- Oncology
- Endocrinology
- Hepatology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer.
- Hypercalcemia is a rare but serious complication of malignancy.
- Humoral hypercalcemia of malignancy is typically associated with parathyroid hormone-related protein (PTHrp).
Observation:
- A case of HCC presenting with hypercalcemia was observed.
- No bone metastasis or elevated PTHrp levels were detected.
- Elevated intact parathyroid hormone (PTH) levels were measured in the serum.
Findings:
- Hepatic venous sampling indicated that the HCC tumor was the source of intact PTH production.
- This suggests a rare mechanism of humoral hypercalcemia driven by ectopic PTH secretion from liver cancer.
- Transcatheter arterial chemoembolization (TACE) was effective in controlling the hypercalcemia.
Implications:
- This case expands the understanding of PTH-mediated hypercalcemia in cancer.
- It highlights the potential for HCC to ectopically produce intact PTH.
- TACE may be a viable therapeutic option for managing hypercalcemia in select HCC patients.