Humoral hypercalcemia caused by uterine corpus carcinosarcoma consisting of squamous cell carcinoma in its epithelial component

J Obstet Gynaecol Res. 2014 Jan;40(1):263-7. doi: 10.1111/jog.12136. Epub 2013 Sep 5.

Abstract

Humoral hypercalcemia of malignancy (HHM) is a paraneoplastic syndrome primarily caused by a tumor-producing parathyroid hormone-related protein (PTH-rP). We describe the first reported case of a uterine carcinosarcoma causing HHM. A 70-year-old patient was transferred to our hospital for a uterine tumor accompanied by impaired consciousness. The laboratory tests indicated anemia, malnutrition, elevated serum calcium and elevated PTH-rP. Emergency surgery, including abdominal hysterectomy and bilateral salpingo-oophorectomy, was performed due to uncontrollable uterine bleeding. The pathological diagnosis was carcinosarcoma consisting of pure squamous cell carcinoma in its epithelial component. Postoperatively, chemotherapy with paclitaxel and carboplatin was performed. The patient had recurrent tumors at the para-aortic lymph nodes 11 months after the initial surgery and underwent a pelvic and para-aortic lymphadenectomy, which removed all of the recurrent tumors.

Keywords: carcinosarcoma; hypercalcemia; parathyroid hormone-related protein; squamous cell carcinoma; uterine neoplasms.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Agents / administration & dosage
  • Antineoplastic Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carboplatin / administration & dosage
  • Carboplatin / therapeutic use
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / physiopathology*
  • Carcinoma, Squamous Cell / surgery
  • Carcinosarcoma / drug therapy
  • Carcinosarcoma / pathology
  • Carcinosarcoma / physiopathology*
  • Carcinosarcoma / surgery
  • Chemotherapy, Adjuvant
  • Endometrium / pathology*
  • Female
  • Humans
  • Hypercalcemia / etiology*
  • Hypercalcemia / prevention & control
  • Hysterectomy
  • Ovariectomy
  • Paclitaxel / administration & dosage
  • Paclitaxel / therapeutic use
  • Paraneoplastic Syndromes / etiology*
  • Paraneoplastic Syndromes / prevention & control
  • Salpingectomy
  • Treatment Outcome
  • Uterine Hemorrhage / etiology
  • Uterine Hemorrhage / prevention & control
  • Uterine Neoplasms / drug therapy
  • Uterine Neoplasms / pathology
  • Uterine Neoplasms / physiopathology*
  • Uterine Neoplasms / surgery
  • Uterus / pathology*
  • Uterus / surgery

Substances

  • Antineoplastic Agents
  • Carboplatin
  • Paclitaxel

Supplementary concepts

  • Humoral Hypercalcemia Of Malignancy