Cholangiocarcinoma Producing Parathyroid Hormone-related Peptide Treated with Chemoradiation Using Gemcitabine and S-1

Yamada, Masayoshi; Shiroeda, Hisakazu; Shiroeda, Shoko; Sato, Katsuaki; Arisawa, Tomiyasu; Tsutsumi, Mikihiro

doi:10.2169/internalmedicine.48.2644

Cited by 14 publications

(12 citation statements)

References 9 publications

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“…Chemotherapy for cholangiocarcinoma is administered to those patients who are not operative and results have been largely disappointing, especially for cholangiocarcinoma that produces PTHrP [4, 16]. To the best of our knowledge, patients diagnosed with a PTHrP-secreting cholangiocarcinoma who lived for more than six months have been reported in only four instances, including the present case (Table 2) [4, 17, 18]; chemotherapy was performed for each case but surgical resection was not. This suggests the possibility that chemotherapy is one of the effective treatments for a PTHrP-secreting cholangiocarcinoma, like a non-PTHrP-secreting cholangiocarcinoma.…”

Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

“…Surgical resection is the only curative treatment for cholangiocarcinoma; however, most patients with this tumor are not operative candidates [4, 16]. Chemotherapy for cholangiocarcinoma is administered to those patients who are not operative and results have been largely disappointing, especially for cholangiocarcinoma that produces PTHrP [4, 16]. To the best of our knowledge, patients diagnosed with a PTHrP-secreting cholangiocarcinoma who lived for more than six months have been reported in only four instances, including the present case (Table 2) [4, 17, 18]; chemotherapy was performed for each case but surgical resection was not.…”

Section: Discussionmentioning

confidence: 99%

“…HHM is associated with 80 percent of MAHs and is caused by the effects of the oversecretion of parathyroid hormone-related peptide (PTHrP) [1–3]. Although HHM can essentially be caused by any tumor [1], its induction by cholangiocarcinoma or gastric cancer (GC) is rare [4, 5]. In addition, to date, cases of HHM complicated by two cancers—cholangiocarcinoma and gastric cancer—have not been reported.…”

Section: Introductionmentioning

confidence: 99%

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Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer

Takeda

Kimura

Nishigaki

et al. 2017

Case Reports in Endocrinology

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Humoral hypercalcemia of malignancy (HHM) is caused by the oversecretion of parathyroid hormone-related peptide (PTHrP) from malignant tumors. Although any tumor may cause HHM, that induced by intrahepatic cholangiocarcinoma (ICC) or gastric cancer (GC) is rare. We report here a 74-year-old male who displayed HHM with both ICC and GC and showed an elevated serum PTHrP level. Treatment of the hypercalcemia with saline, furosemide, elcatonin, and zoledronic acid corrected his serum calcium level and improved symptoms. Because treatment of ICC should precede that of GC, we chose chemotherapy with cisplatin (CDDP) and gemcitabine (GEM). Chemotherapy reduced the size of the ICC and decreased the serum PTHrP level. One year after diagnosis, the patient was alive in the face of a poor prognosis for an ICC that produced PTHrP. Immunohistochemical staining for PTHrP was positive for the ICC and negative for the GC, leading us to believe that the cause of the HHM was a PTHrP-secreting ICC. In conclusion, immunohistochemical staining for PTHrP may be useful in discovering the cause of HHM in the case of two cancers accompanied by an elevated serum PHTrP level. Chemotherapy with CDDP and GEM may be the most appropriate treatment for a PTHrP-secreting ICC.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer

Takeda

Kimura

Nishigaki

et al. 2017

Case Reports in Endocrinology

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“…Only two case studies showing longer survival time than one year after initial diagnosis of HHM with CC have been reported [9,10]. In one case report, the patient underwent right portal vein embolization and chemoembolization followed by extended right hepatectomy, and survived three and one half years [10].…”

Section: Discussionmentioning

confidence: 99%

Two Cases of Humoral Hypercalcemia of Malignancy in Metastatic Cholangiocarcinoma

et al. 2013

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Humoral hypercalcemia of malignancy (HHM) is rarely associated with cholangiocarcinoma (CC), and represents dismal prognosis. A 63-year-old male was admitted for evaluation of an intrahepatic mass. He was diagnosed with HHM associated with locally advanced CC. As the tumor responded to the concurrent chemoradiotherapy with capecitabine and cisplatin, serum calcium level was normalized. However, according to the disease progression, he suffered recurrence of HHM and he expired approximately one year after initial diagnosis. A 68-year-old male who presented with abdominal pain was diagnosed with metastatic CC. After the eighth cycle of gemcitabine and cisplatin, progression of the disease was found with HHM. He was treated with the best supportive care, until his demise approximately one month after the diagnosis of HHM. We report on two cases of HHM associated with CC that demonstrate strong correlation between hypercalcemia and disease burden.

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Markers and Immunoprofile of Tumors of Endocrine Organs and Neuroendocrine Tumors

Tuffaha,

Guski,

Kristiansen

2023

Immunohistochemistry in Tumor Diagnostics

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Cholangiocarcinoma Producing Parathyroid Hormone-related Peptide Treated with Chemoradiation Using Gemcitabine and S-1

Abstract: Abstract

Cited by 14 publications

References 9 publications

Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer

Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer

Two Cases of Humoral Hypercalcemia of Malignancy in Metastatic Cholangiocarcinoma

Markers and Immunoprofile of Tumors of Endocrine Organs and Neuroendocrine Tumors

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