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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A cell line was established from undifferentiated giant cell carcinoma of the thyroid. The authors obtained cells from a 44-year-old patient admitted because of a rapidly growing anterior neck mass. The patient had significant leukocytosis and hypercalcemia shortly before her death. An autopsy revealed epidermoid metaplasia of the tumor cells. The cells (HTC/C3) had lost most of their differentiated functions. However, their thyroid nature was shown by peroxidase staining and by enzyme-linked immunostaining with Hashimoto patients' sera. The tumor extract was found to contain parathyroid (PTH)-like activity. Significant amounts of colony stimulating factor (CSF), which was further defined to be GM-CSF, and interleukin-1 alpha (IL-1 alpha) were detected in the conditioned media. Epidermal growth factor (EGF) binding to the HTC/C3 showed rich EGF receptors. Furthermore, the conditioned medium inhibited the binding of 125I-mEGF to HeLa cells, and transforming growth factor (TGF) was found repeatedly in the media.
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PMID:Establishment of a human undifferentiated thyroid cancer cell line producing several growth factors and cytokines. 219 88

Hypercalcemia was previously considered a terminal phenomenon in advanced head and neck squamous-cell carcinoma. We report on six patients with head and neck carcinoma and hypercalcemia refractory to conventional measures. Three patients had stage IV tumor not amenable to surgery or radiation therapy and three others had carcinoma recurrent after surgery and/or radiation therapy. Five of the six patients had paraneoplastic hypercalcemia and one had extensive bone metastases. One refused chemotherapy and died in 2 months. Five treated with cisplatin 100 mg/m2 i.v. and 5-fluorouracil (5-FU) 960 mg/m2/day x 5, on days 2-7 as a continuous infusion, had prolonged control of hypercalcemia and required no other therapy to maintain eucalcemia. All three patients with no prior therapy, and one of the two patients with recurrent cancer, had a partial response after chemotherapy. The survivals of the patients with recurrent cancer were 1 and 3 months. The survivals in the patients with no prior antitumor therapy were 10, 11+, and 23 months, respectively. In conclusion, hypercalcemia in head and neck carcinoma can be well controlled by cisplatin and 5-FU chemotherapy for a prolonged period. The impact of chemotherapy on survival was minimal in patients with recurrent cancer. In contrast, patients with hypercalcemia at initial presentation of an advanced head and neck cancer have a high likelihood of tumor control and prolongation of survival by chemotherapy.
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PMID:Hypercalcemia in head and neck squamous-cell carcinoma. 222 Jun 59

To determine the causes of failures of cervical exploration for primary hyperparathyroidism, we reviewed 892 patients operated on by one surgeon from 1953 to 1990. Twenty-seven patients (3%) remained hypercalcemic or developed hypercalcemia within 6 months of surgery. Of these, five patients had one adenoma removed initially; at reoperation, three patients had a second adenoma that was successfully removed, whereas the other two patients had hyperplasia and required subtotal parathyroidectomies. No enlarged parathyroid glands were identified in 22 patients. Eventually, six patients became normocalcemic spontaneously, seven patients underwent re-exploration with a successful outcome in all but one case, two patients had ectopic hyperparathyroidism associated with carcinoma elsewhere, and seven patients refused reoperation and remain hypercalcemic. The failure rate of surgical exploration for primary hyperparathyroidism can be reduced by systematically exploring all four parathyroid glands. All abnormal parathyroids should be removed with histologic verification. When no abnormal glands are found, localization studies should be performed before re-exploration.
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PMID:Initial failure of surgical exploration in patients with primary hyperparathyroidism. 222 Dec 29

Although fistulae and hypercalcemia are rare at the time of diagnosis of esophageal carcinoma, they are not uncommon terminal events. Most fistulae communicate with the respiratory tract. Uncommon sites of fistulae due to esophageal carcinoma include extension to the aorta, pleura, pericardium, and mediastinum. We report a patient with a spontaneous pneumomediastinum discovered during radiologic staging of esophageal carcinoma. The symptoms were dysphagia, weight loss, and pneumonia. The patient had hypercalcemia refractory to conventional measures, another adverse prognostic factor. Cisplatin 100 mg/m2 was tolerated without acute toxicity and lowered the serum calcium to normal. However, the patient died due to respiratory failure 2 days after cisplatin therapy. To our knowledge, this is the first report of a spontaneous pneumomediastinum at presentation of an esophageal carcinoma. The course of our patient and a review of the literature suggest that fistulae and/or hypercalcemia are medical emergencies and are often fatal in esophageal carcinoma.
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PMID:Spontaneous pneumomediastinum in esophageal carcinoma. 223 8

Parathyroid tumors account for only a small percentage of all head and neck neoplasms. The overwhelming majority of these are parathyroid adenomas that result in primary hyperparathyroidism. From 0.5% to 4% of hyperparathyroid patients, however, will be found to have a parathyroid carcinoma. In this paper, the authors relate their recent experience with such a patient and with two other such cases. Parathyroid carcinoma patients usually present with striking hyperparathyroidism and hypercalcemia, with the resultant related symptoms being more severe than those associated with parathyroid adenomas. Parathyroid carcinomas also tend to be large and may be detectable by current imaging techniques. The surgical appearance of these lesions is also distinct; the tumors are frequently multilobulated, gray-tan in color, quite firm, and often invasive. These physical findings are important since frozen section diagnosis may be difficult. The final histologic diagnosis depends on the presence of mitotic figures and capsular and vascular invasions. Preoperative medical problems, surgical approach, and prognostic factors are also discussed.
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PMID:Parathyroid carcinoma: clinical presentation and treatment. 224 Apr 16

Little notice has been paid in the surgical literature to problems with psychoeffective lithium, which by interfering with adenylate cyclase affects thyroid and parathyroid function, causing hypercalcemia, hyperparathyroidism, and hypothyroidism. Seven patients with lithiumogenic hyperparathyroidism occurring after years of lithium therapy underwent treatment and manifested osteoporosis (n = 2), hypertension (n = 2), nephrolithiasis (n = 1), coma (n = 1), rising hypercalcemia (n = 1), goitrous myxedema (n = 4), nephrogenic diabetes insipidus (n = 2), renal failure (n = 2), and hyperlipidemia (n = 1). Disease-directed parathyroidectomy (without morbidity) was curative. Unique laboratory findings included normal serum phosphorus and reduced urinary calcium and cyclic adenosine monophosphate values. Three separate cases of thyroid carcinoma after long-term lithium therapy were also treated, being preceded by myxedema (n = 2) and concurrent with hyperparathyroidism (n = 1). There has been only one previous report of lithium-associated thyroid carcinoma. All patients taking lithium should undergo surveillance for thyroid and parathyroid dysfunction and neoplasia, and appropriate surgical and medical treatment should be considered in each situation. Although hyperparathyroidism may be reversible with lithium discontinuance, such therapy may be obligatory for patient well-being, thus dictating parathyroidectomy.
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PMID:Lithiumogenic disorders of the thyroid and parathyroid glands as surgical disease. 224 24

Discussed is the case of a 50-year-old man with a well advanced esophageal carcinoma who, during his final clinical course, suddenly developed hypercalcemia (max: 15.0 mg/ml). His serum parathyroid hormone level, however, remained within normal limits. On autopsy, an extensive metastasis to many organs and lymph nodes was noted but no evidence of a bone metastasis. Nude mice bearing the same tumoral tissue were found, on autopsy, to have similarly developed hypercalcemia and cells that were cultured were found to produce an excessive amount of Prostaglandin E2 (PGE2). These findings suggest that this humoral hypercalcemia of malignancy (HHM) was caused by excessive PGE2 produced by the tumor cells, although other possible factors should be investigated.
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PMID:[Esophageal carcinoma with hypercalcemia that appeared to be caused by prostaglandin E2 produced by the tumor cells]. 225 Mar 67

31 cases of primary hyperplasia and neoplasms of the parathyroid gland are reported. Among them, 23 cases were parathyroid adenoma, 6 cases parathyroid hyperplasia, one case adenoma associated with hyperplasia, and one case of parathyroid adenocarcinoma. Follow-up study demonstrated that prognosis in the adenoma group is better than that in the hyperplasia group, and one carcinoma patient died from metastasis. Regarding differential diagnosis, adenoma is usually single, with frequent presence of oppressed parathyroid tissue next to the tumor capsule; and cell atypical hyperplasia is often seen microscopically, which is usually multiple in sites, and some residual adipose tissue can be found under the microscope. Clinically, both groups manifested hypercalcemia and hypophosphatemia, especially in those cases with chief cell hyperplasia. Capsule infiltration and vascular embolism are emphasized as the differential features between benign and malignant parathyroid tumours.
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PMID:[A clinico-pathologic study of 31 cases of parathyroid hyperplasia and tumours]. 227 14

To determine the incidence and causes of hypercalcaemia in a hospital population in Hong Kong, all 29,107 samples received in the laboratory in one year were analysed for plasma calcium and albumin, and samples with a plasma calcium concentration adjusted for albumin greater than 2.55 mmol/l were investigated. Plasma calcium greater than 2.55 mmol/l was found in 462 patients. Repeat samples were received from 302 of these and hypercalcaemia was confirmed in 183. The main causes of hypercalcaemia were malignancy (72.1 per cent), tuberculosis (6.0 per cent), and primary hyperparathyroidism (5.5 per cent). In the malignant hypercalcaemia group, carcinoma of lung was the most common (31.8 per cent) and carcinoma of breast was uncommon (3.0 per cent). Secondary deposits in bone were detected in 35 of the 122 solid tumours. In order to identify the mechanism of hypercalcaemia the contributions of renal tubular reabsorption and increased bone resorption to the plasma calcium concentration were calculated. Increased tubular reabsorption was the main contributor to hypercalcaemia in primary hyperparathyroidism and carcinoma of liver (none of whom had bony metastases) and it contributed significantly to hypercalcaemia in carcinoma of lung without bony metastases and carcinoma of oesophagus. We conclude that in Hong Kong (a) primary hyperparathyroidism is uncommon, (b) tuberculosis is an important cause and (c) humoral factors may be responsible for a relatively high proportion of cases of malignant hypercalcaemia.
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PMID:Incidence, causes and mechanism of hypercalcaemia in a hospital population in Hong Kong. 229 Sep 21

We report a case of nasopharyngeal squamous carcinoma complicated by diabetes insipidus and hypercalcaemia. As there was no evidence of bony metastases we conclude that this latter finding was due to a humoral factor produced by the tumour. The management of these problems is discussed.
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PMID:Diabetes insipidus and hypercalcaemia secondary to nasopharyngeal carcinoma. 231 77


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