Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020437 (hypercalcemia)
 10,293 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The case history of a 26 year old woman describes the occurrence of a primary cholangiocarcinoma in the woman's liver during her 1st pregnancy with no signs of skeletal metastasis. During the previous 8 years, she had taken oral contraceptives (Microgynon 50). The case was successfully treated with chemotherapy (treatment with APD) and surgical removal of the tumor. It was considered highly unusual since malignant tumors of the liver occur seldom in the West, and very seldom among young people. Most patients are over 50; the illness strikes nearly twice as often in men as women. A tumor occurs in a cirrhotic liver in about 75% of cases; and, indications reveal that persistent hepatitis B plays a role in the development of hepatocellular carcinomas. The patient did not fit into any of the those categories. The patient's initial complaints occurred during her pregnancy. Previous medical literature has described patients with a malignant tumor of the liver during pregnany, and since 1970, many articles have shown a relationship between hepatic dysfunctions in women and the use of oral contraceptives. The benign dysfunctions usually involved liver cell edema and focalized nodular hyperplasia. Malignant liver tumors in such patients have been less frequently described in the literature; thus, their relationship with the use of oral contraceptives is less certain. Artlcles have appeared, however, indicating a connection between liver malignancy and the use of sex hormones. There are also indications that humoral hypercalcemia is a frequent finding in primary liver cancer.
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PMID:[A young woman with a liver tumor and hypercalcemia]. 302 Apr 47

Recent reports have suggested that the sensitivity to chemotherapy of endocrine-dependent breast cancer may be enhanced by transient exposure to hormonal stimulation. To test this concept, 39 postmenopausal women with proven metastatic breast carcinoma and measurable disease were entered into this prospective, double-blind trial; 35 are currently evaluable. All patients were continuously treated with aminoglutethimide and hydrocortisone to lower estrogen production, plus cyclic chemotherapy. Patients in the "stimulation" arm received in addition, Estrace 2 mg b.i.d. sublingually for 3 days before and on the day of chemotherapy. Estrace administration appeared to accelerate tumor growth as demonstrated by increased bone pain, hypercalcemia, and growth of skin lesions. Response rates, response duration, and survival were similar in the stimulation and control groups.
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PMID:A randomized trial of aminoglutethimide +/- estrogen before chemotherapy in advanced breast cancer. 354 14

An analysis of the development of the vitellogenic process following artificial hibernation in the lizard Lacerta vivipara was undertaken. For that purpose, organ weights (ovaries, oviducts, liver, fat bodies) and plasma concentrations of total proteins, calcium, and estrogens were monitored. The induction of the vitellogenic growth of 2-5 oocytes per ovary was characterized by a rapid increase in calcemia (from 2.4-2.6 mM to 4-10 mM), and in oviduct and liver weights. During the active and continuous phase of vitellus incorporation (congruent to 3 weeks, follicle diameter 1.6-2.0 mm to greater than 5 mm) the developments of ovaries and oviducts were positively correlated, liver weight and calcemia remained elevated (respectively, 1.2-2.2 times and 2.5-3.5 times the previtellogenic values). Ovulation was preceded by a significant rise in calcemia and followed by a decrease in liver weight, but no modification of oviduct mass. Plasma concentration in total proteins (50-60 mg/ml) was not modified during the entire process. Plasma estrogens were difficult to measure in this small species. Levels of estradiol-17 beta were very often below the assay sensitivity (less than 0.3-0.6 ng/ml), never above 2 ng/ml, and very variable among individuals. No correlation with vitellogenin production could be established. Therefore, the abilities of different ovarian steroids to induce vitellogenin synthesis were tested in vivo. To reduce the rise of plasma estradiol titer (observed during a 4-week experiment), the steroids were implanted in ovariectomized lizards for a short time (5 days). The vitellogenic response was assessed by measuring the distribution of the 32P radioactivity between the acidoprecipitable plasma fraction and the plasma vitellogenin recognized by the lizard antivitellogenin serum. Plasma titers of estradiol-17 beta were monitored. The estrone potencies could not be determined as this treatment involved an important rise in estradiol level. Progesterone, delta 4, testosterone, and 5 alpha-androstanediol were unable to stimulate vitellogenin synthesis. Estradiol-17 beta was the only effective steroid. It was further demonstrated that the estradiol-induced hypercalcemia, hyperproteinemia, and liver growth in ovariectomized lizards were dependent upon the total amount of estrogen injected.
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PMID:Vitellogenesis in the lizard Lacerta vivipara jacquin. II. Vitellogenin synthesis during the reproductive cycle and its control by ovarian steroids. 377 Apr 43

A 21-year-old woman presented with a 12-month history of epigastric pain, and for 3 months she had noticed a mass in the right hypochondrium. She had taken 'Norinyl-1' (norethisterone 1 mg and mestranol 50 mcg) for 5 years. She smoked 20 cigarettes a day but drank little alcohol. Physical examination revealed irregular hard hepatomegaly 10 cm below the right costal margin. Hepatitis B surface antigen was not detected in the serum and alpha fetoprotein levels were normal ( 10 M.R.C. units). A liver scan showed a large space-occupying lesion in the right lobe of the liver, and liver biopsy revealed a cholangicarcinoma with striking fibrous reaction. Multiple shadows consistent with metastases were present on chest X-ray, but no bony deposits were found on radiological skeletal survey or bone scan. The serum calcium was persistently high (2.74-2.92 mmol/l) but fell on prednisolone therapy. Serum parathyroid hormone levels were normal. A causal relation between oral contraceptives and hepatic adenoma is now generally accepted, and several patients with hepatocellular carcinoma have also been reported. We have been able to find only 1 previous report of cholangiocarcinoma in a young female taking oral contraceptives, and there is 1 report of this tumor in a man taking high doses of anabolic steroids for refractory anemia. This tumor has its peak incidence in the 6th decade and is very rare in the 3rd decade. The association with hypercalcemia due to pseudohyperparathyroidism is well recognized. In only some cases are parathyroid hormone levels raised, and the cause of the pseudohypercalcemia in our patient is unknown.
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PMID:Cholangiocarcinoma and oral contraceptives. 610 61

In a randomized study, 63 postmenopausal patients with advanced breast cancer were treated with ethinyl estradiol (EE2) or the antiestrogen tamoxifen to compare the efficacy and side effects of both drugs. EE2 was always given in combination with chlorothiazide to prevent fluid retention. Pretreatment characteristics of the patients of both groups did not differ significantly. Objective remissions were achieved in 31% of the EE2-treated patients and in 33% of the tamoxifen-treated patients. The median duration of remission was 12 months (range, 5-32) for the EE2 group and 11 months (range, 5-26) for the tamoxifen group (P greater than 0.1), and the estimated median survival times from the start of treatment were 31 and 25 months, respectively (P greater than 0.1). The best treatment results in both groups were obtained in patients with estradiol receptor-positive tumors and less advanced disease. After therapy was stopped, objective withdrawal responses were observed in EE2- but not in tamoxifen-treated patients. Two patients receiving EE2 had to discontinue treatment because of drug-related liver function impairment. Both patients had cholelithiasis. Two patients in the tamoxifen-treated group discontinued therapy because of nausea. Deep venous thrombosis occurred in one patient receiving EE2, whereas two patients receiving tamoxifen developed superficial thrombophlebitis. Other side effects in both groups of patients, including initial hypercalcemia, were mild. It is concluded that both treatment regimens, EE2 or tamoxifen, are equally effective with respect to induction and duration of remission in postmenopausal patients with advanced breast cancer. Side effects of EE2 therapy appeared to be more serious than those of tamoxifen treatment.
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PMID:Tamoxifen versus ethinyl estradiol in the treatment of postmenopausal women with advanced breast cancer. 723 48