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Malignant Hypercalcemia Induced by a Parathyroid Hormone-Related Protein Secreted by a Cutaneous Squamous Cell Carcinoma

Béatrix Reynaud-Mendel, MD; Caroline Robert, MD; Béatrice Flageul, MD; Marie-Christine de Vernejoul, MD; Olivier Verola, MD; Louis Dubertret, MD
[+] Author Affiliations

Service de Dermatologie Hôpital St Louis 1 Av Claude Vellefaux 75010 Paris, France

Paris


Arch Dermatol. 1997;133(1):113-113. doi:10.1001/archderm.1997.03890370125030
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Hypercalcemia associated with cancer can result from osteolytic metastases, but in most cases hypercalcemia results from tumoral secretion of a parathyroid hormone—related protein (PTHRP), an analogue of the parathyroid hormone purified recently.1 Squamous cell carcinoma (SCC) of the lung and oral cavity and breast adenocarcinoma are the most common causes of this paraneoplastic syndrome, also called humoral hypercalcemia of malignancy (HHM).

We report the first case, to our knowledge, of HHM associated with an extensive metastatic cutaneous SCC.

Report of a Case.  A 53-year-old man presented with a voluminous ulcerated tumor of the upper back, which had developed over a 15-year period (Figure). Large axillary lymph nodes appeared 3 years prior to our examination. A complete blood count showed hyperleukocytosis and thrombocytosis. Results of renal and liver function tests and human immunodeficiency virus type 1 and 2 serologic tests were normal or negative. Severe hypercalcemia was present at calcium

REFERENCES

Merendino JJ, Insogna KL, Milstone LM, Broadus AE, Stewart AF.  A parathyroid hormone-like protein from cultured human keratinocytes . Science . 1986;; 231:388-390.
Hanafin NM, Chen TC, Heinrich G, Segre GV, Holick MF.  Cultured human fibroblasts and not cultured human keratinocytes express a PTH/PTH-rP receptor mRNA . J Invest Dermatol. 1995;;105:133-137.
Hayman JA, Danks JA, Ebeling PR, Moseley JM, Kemp BE, Martin TJ.  Expression of parathyroid hormone related protein in normal skin and in tumours of skin and skin appendages . J Pathol. 1989;;158:293-296.
Danks JA, Ebeling PR, Hayman JA, et al.  Parathyroid hormone-related protein: immunohistochemical localization in cancers and in normal skin . J Bone Miner Res. 1989;;4:273-278.

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Merendino JJ, Insogna KL, Milstone LM, Broadus AE, Stewart AF.  A parathyroid hormone-like protein from cultured human keratinocytes . Science . 1986;; 231:388-390.
Hanafin NM, Chen TC, Heinrich G, Segre GV, Holick MF.  Cultured human fibroblasts and not cultured human keratinocytes express a PTH/PTH-rP receptor mRNA . J Invest Dermatol. 1995;;105:133-137.
Hayman JA, Danks JA, Ebeling PR, Moseley JM, Kemp BE, Martin TJ.  Expression of parathyroid hormone related protein in normal skin and in tumours of skin and skin appendages . J Pathol. 1989;;158:293-296.
Danks JA, Ebeling PR, Hayman JA, et al.  Parathyroid hormone-related protein: immunohistochemical localization in cancers and in normal skin . J Bone Miner Res. 1989;;4:273-278.

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