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

A women with hypercalcemia and a hypernephroma confined to the left kidney underwent nephrectomy and subsequent resolution of hypercalcemia. Serum parathyroid hormone was undetectable in peripheral blood as well as in the left renal vein at surgery. Parathyroid hormone was also undetectable in the tumor extract using three different antisera to parathyroid hormone. Measurement of plasma prostaglandin E and 13, 14-dihydro-15-keto-prostaglandin E2 revealed levels within the normal range. The serum 1,25-dihydroxyvitamin D concentration was below normal and nephrogenous cyclic adenosine monophosphate was markedly elevated. The humoral agent responsible for hypercalcemia in this patient was not identified. This case emphasizes the need to search for new hypercalcemic factors in patients with hypercalcemia of malignancy.
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PMID:Humoral hypercalcemia of malignancy: a syndrome in search of a hormone. 629 89

When grown in nude mice, cultured renal carcinoma cells from a hypercalcemic patient produced marked hypercalcemia that was reversed by resection of tumor. Conditioned medium from this cell line contained a protein with activity in a renal adenylate cyclase bioassay for parathyroid hormone (PTH) which was blocked by the competitive PTH antagonist [8norleucyl, 18norleucyl, 34tyrosinyl]bPTH (3-34)amide. However, the biologically active protein was eluted from gel filtration columns as a larger molecular size component that PTH and was not recognized by any of four region-specific PTH antisera. The properties of this factor resemble those of the postulated PTH-like substance(s) in humoral hypercalcemia of malignancy.
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PMID:Human renal carcinoma cells produce hypercalcemia in the nude mouse and a novel protein recognized by parathyroid hormone receptors. 629 82

Twenty cases (3.3%) of hypercalcemia of more than 11.0 mg/dl associated with urogenital malignancy were observed in 610 inpatients during the past 5 years and 6 months (Jan. 1978-June 1983). Incidences were 10 (16.1%) out of 62 cases of renal cell carcinoma, 6 (1.9%) out of 321 cases of bladder cancer, 3 (6.7%) out of 45 cases of renal pelvic and ureteral cancer, and one (1.1%) out of 95 cases of prostatic cancer. As treatment, surgery (radical nephrectomy) and anti-cancer chemotherapy were effective in 3 cases (2 renal cell carcinomas and one renal pelvic cancer). Conservative therapy with hydration combined with either indomethacin, steroid or eel calcitonin was effective in 11 cases, and s-Ca level was decreased by 3.7 mg/dl on the average. Eighteen patients were in the terminal stage of malignancy when hypercalcemia was observed, and died 5 days to 9 months (mean; 2 months) after the onset of hypercalcemia.
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PMID:[20 cases of hypercalcemia associated with urogenital malignancies]. 647 83

Sarcomatous proliferation of the fibroblast-like stromal cells in renal cell carcinoma was found in three patients who had apparently tumor-associated hypercalcemia but no evidence of bone metastases. The proliferation of stromal cells was not found in 20 patients who also had renal cell carcinoma without hypercalcemia. Immunoreactive parathormone-like substance was detected in two of the three patients with hypercalcemia, despite high levels of serum calcium. The parathormone assay was not conducted on the third hypercalcemic patient, however. Buffer extract from one of the tumors associated with hypercalcemia was able to elicit an increase of the serum calcium in rats, whereas buffer extract from a tumor not associated with hypercalcemia failed to induce hypercalcemia in rats. Findings suggest that the stromal cells of renal cell carcinoma may play a role in the tumor-associated hypercalcemia. The exact nature of the hypercalcemic agent is uncertain. However, in the case studied it appears that a parathormone-like substance was responsible.
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PMID:Hypercalcemia associated with renal cell carcinoma: probable role of neoplastic stromal cells. 683 61

A 63-year-old man with iron loss anaemia and hypercalcaemia was found to have a renal cell carcinoma. Despite the iron-deficient blood and bone marrow picture, the serum ferritin concentration was markedly raised. This was mainly due to a "basic isoferritin". The serum parathormone concentration was normal. The serum ferritin and calcium concentrations returned to normal after the tumour was removed. We propose that the renal cell carcinoma cells in this patient secreted the basic isoferritin as well as humoral factor(s) responsible for hypercalcaemia.
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PMID:Basic isoferritin and hypercalcaemia in renal cell carcinoma. 711 19

During the past 16 years, in which 1,600 patients were surgically treated for primary hyperparathyroidism, 10 of these patients also were operated on for hypernephroma; in another patient a hypernephroma was detected 7 2/3 years after treatment for hyperparathyroidism. Four additional patients have elevated serum calcium and immunoreactive parathyroid hormone values after nephrectomy for hypernephroma, and a provisional diagnosis of primary hyperparathyroidism has been made in these patients. Thus, the occurrence in the same patient of two disorders that may have similar biochemical abnormalities produced by similar pathophysiologic mechanisms provides a unique diagnostic challenge to the physician. The correct diagnosis of these occasionally associated disorders is facilitated by a high degree of alertness and the performance of adequate renal radiographic procedures. These should include excretory urography in patients with persistent hypercalcemia unless the procedure is contraindicated.
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PMID:Primary hyperparathyroidism associated with hypernephroma: a diagnostic challenge. 713 30

Multiple systemic manifestations of renal cell carcinoma have been reported. The first case of a discoid lupus erythematosus-like syndrome and the third reported case of hypercalcemia associated with an elevated serum prostaglandin E2 level in a patient with renal cell carcinoma is presented herein.
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PMID:Hypercalcemia and discoid lupus erythematosus-like syndrome associated with renal cell carcinoma. 741 40

The development of renal cell neoplasms ranging from adenoma to metastatic carcinoma is the most serious complication of acquired cystic kidney disease (ACKD). A comprehensive review of the pertinent literature shows that there is up to 50-fold increased risk of renal cell carcinoma in ACKD compared to the general population. The ACKD-associated renal cell carcinoma is seen predominantly in males, occurs approximately 20 years earlier than in the general population, and is frequently bilateral (9%) and multicentric (50%). Acquired cystic kidney disease-associated renal cell carcinoma is frequently asymptomatic (86%), but may be associated with bleeding, abrupt changes in hematocrit, fever, and flank pain or rarely with hypoglycemia, hypercalcemia, or metastases at presentation. Computed tomography seems to provide a better diagnostic yield than sonography or magnetic resonance imaging; nevertheless, large (up to 8 cm) tumors not visualized by any imaging techniques have been reported. It is generally agreed that there is a need for regular screening of symptomatic ACKD patients for early detection of renal cell carcinoma; however, whether screening is needed for asymptomatic patients remains controversial. Nephrectomy is indicated for tumors larger than 3 cm. Management for tumors smaller than 3 cm with persistent symptoms, such as back pain or hematuria, remains controversial, but nephrectomy may be recommended since many of these tumors turn out to be unequivocal renal cell carcinoma. Asymptomatic tumors smaller than 3 cm should be serially screened, and tumor enlargement may be an indication for nephrectomy. Acquired cystic kidney disease-associated renal cell carcinoma accounts for approximately 2% of deaths in renal transplant patients. A median length of survival of approximately 14 months and a 5-year survival rate of 35% are comparable to the same data for renal cell carcinoma in the general population. Successful renal transplant probably decreases the risk of renal cell carcinoma in ACKD patients, but this preliminary observation needs confirmation. The development of ACKD-associated renal carcinoma is a continuous process with evolving phenotypic expression, including damaged renal tubule, simple cyst, cyst with atypical lining, adenoma, and, finally, carcinoma. The pathogenesis of this continuous process is not entirely known, but growth factor-induced compensatory growth of tubular epithelium initiated by the changes of end-stage kidney disease, and probably perpetuated by activation of proto-oncogenes, seems to be the most significant factor.
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PMID:Renal neoplasm in acquired cystic kidney disease. 761 Dec 40

The simultaneous occurrence of renal cell carcinoma(RCC) and transitional cell carcinoma(TCC) in the same kidney is unusual. We report a 53-year-old man with ipsilateral synchronous renal adenocarcinoma and renal pelvic transitional cell carcinoma with severe hypercalcemia and a huge staghorn calculus in the opposite kidney. The patient was admitted to the hospital because of left flank pain and intermittent fever which he had had for 2 months. Computerized tomography revealed a huge stone in the right kidney and a mass in the upper pole with an irregular calcified pelvis in the left enlarged kidney. Left radical nephrectomy was done. A section of the specimen revealed a renal cell carcinoma located at the upper pole and a papillary transitional cell carcinoma arising from the renal pelvis. This is a rare case of combined renal malignancies.
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PMID:Ipsilateral synchronous renal cell carcinoma and transitional cell carcinoma. 778 42

Hypercalcemia may be a manifestation of a variety of disorders including hyperparathyroidism, hypervitaminosis D, sarcoidosis, multiple myeloma, hyperthyroidism, acute osteoporosis, metastatic bone disease, and a number of primary malignancies. Hypercalcemia may be seen in as many as 1.5% of all patients with malignant disease, with or without bony metastases. The neoplasms most commonly associated with hypercalcemia include carcinoma of the lung (all cell types), breast cancer, squamous cell carcinomas, hematologic malignancies, and renal cell carcinoma. Observation of a number of instances of hypercalcemia attendant on urologic malignancies prompts the brief report of 4 characteristic cases with documentation of response to therapy. Management of severe and debilitating hypercalcemia is emphasized. Urologists should be aware of new agents available for such treatment.
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PMID:Hypercalcemia and urologic malignancies. 781 68


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