[Hypercalcemia related to PTH-rP revealing malignant hepatic epithelioid hemangioendothelioma]

Ann Biol Clin (Paris). 2016 Jan-Feb;74(1):98-102. doi: 10.1684/abc.2015.1118.
[Article in French]

Abstract

Hypercalcemia caused by tumor production of PTH-rp occurs most often in cases of squamous cell carcinoma of the lung, aerodigestive tract cancer, gynecological cancer and lymphoma. We report an exceptional case of PTH-rp related to a hepatic hemangioendothelioma. A 70 years-old male admitted for deterioration of the general state. The laboratory investigations revealed hypercalcemia, related to tumor production of PTH-rp. Imaging revealed tumoral hepatic lesions. Histopathological study and immunohistochemistry showed diffuse response for CD31 marker, CK20 (+) with CK7 (-) and hepatocyt antigen (-). The diagnosis of PTH-rp related to hepatic hemangioendothelioma was make. The patient died with recurrence of fatal hypercalcemia. Management of patients presenting with humoral hypercalcemia includes a vigorous search for tumor lesions. Elevated PTH-rp can be a bad prognostic factor. In front of tumoral liver lesions, a hepatic epithelioid hemangioendothelioma must be considered. Immunohistochemistry is necessary to make diagnosis.

Keywords: PTH-rp; hemangioendothelioma; hypercalcemia; liver.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Hemangioendothelioma, Epithelioid / complications*
  • Hemangioendothelioma, Epithelioid / metabolism
  • Hemangioendothelioma, Epithelioid / pathology
  • Humans
  • Hypercalcemia / etiology*
  • Liver Neoplasms / complications*
  • Liver Neoplasms / metabolism
  • Liver Neoplasms / pathology
  • Male
  • Paraneoplastic Endocrine Syndromes / etiology
  • Paraneoplastic Endocrine Syndromes / pathology
  • Parathyroid Hormone-Related Protein / metabolism
  • Parathyroid Hormone-Related Protein / physiology*

Substances

  • PTHLH protein, human
  • Parathyroid Hormone-Related Protein