Hepatic arterial embolization for malignant hypercalcemia in hepatocellular carcinoma

Attali, P; Houssin, D; Roche, Alain; Buffet, Catherine; Bismuth, H; Étienne, J

doi:10.1007/bf01296226

Cited by 14 publications

(9 citation statements)

References 13 publications

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“…Treatment of HCC, either via surgical resection or TACE, has been shown to abrogate PNS [16]. Paraneoplastic activity is related to overall tumor burden and biological activity of the neoplastic hepatocytes, which are significantly reduced with effective treatment of the disease and may reappear in tandem with recurrence of HCC [17]. …”

Section: Discussionmentioning

confidence: 99%

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

et al. 2013

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Background. Paraneoplastic syndromes (PNS) such as hypercalcaemia, hypercholesterolaemia, and erythrocytosis have been described in hepatocellular carcinoma (HCC). Aims. (1) To examine the prevalence, clinical characteristics, and survival of PNS in HCC patients and (2) to evaluate the extent to which each individual PNS impacts on patient survival. Methods. We prospectively evaluated the prevalence, clinical characteristics, and survival of PNS among 457 consecutive HCC patients seen in our department over a 10-year period and compared them with HCC patients without PNS. Results. PNS were present in 127 patients (27.8%). The prevalence of paraneoplastic hypercholesterolemia, hypercalcemia, and erythrocytosis 24.5%, 5.3%, and 3.9%, respectively. Patients with PNS had significantly higher alpha-fetoprotein levels, more advanced TNM stage, and shorter survival. Among the individual PNS, hypercalcemia and hypercholesterolemia were associated with more advanced disease and reduced survival but not erythrocytosis. On multivariate analysis, the presence of PNS was not found to be an independent prognostic factor for reduced HCC survival. Conclusion. PNS are not uncommon in HCC and are associated with poor prognosis and reduced survival due to their association with increased tumor burden. However, they do not independently predict poor survival. Individual PNS impact differently on HCC outcome; paraneoplastic hypercalcemia in particular is associated with poor outcome.

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Section: Discussionmentioning

confidence: 99%

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

et al. 2013

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“…The association between hypercalcemia and hepatic malignancy is rare, with a prevalence ranging from 1.5% to 40% in different reports (3,12). It was suggested that the inclusion or exclusion of patients with documented metastasis might have accounted for this big variation.…”

Section: Discussionmentioning

confidence: 99%

“…Hypercalcemia has been described mainly with hepatocellular carcinoma and cholangiocarcinoma (3). A distinct histological subtype called 'sclerosing hepatic carcinoma' has been strongly linked to hypercalcemia in the absence of bony metastasis (10,12).…”

Section: Discussionmentioning

confidence: 99%

“…While a diversity of alterations in laboratory results can be observed in these patients, hypercalcemia is uncommon (3,11). When hypercalcemia does occur, it is mainly caused by a local osteolytic effect of bone metastasis (12). Intrinsic hypercalcemia, caused by a humoral secretion from cancer cells and manifesting as the initial presentation of hepatocellular carcinoma, is extremely rare.…”

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confidence: 99%

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Severe Hypercalcemia as an Initial Presenting Manifestation of Hepatocellular Carcinoma

Ghobrial

George

Mannam

et al. 2002

Canadian Journal of Gastroenterology

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An 80-year-old white woman who presented with fatigue, weakness, weight loss, constipation and polydipsia is reported. The patient was given a diagnosis of severe hypercalcemia and was subsequently found to have clinical, roentgenographic and pathological evidence of hepatocellular carcinoma. Further studies revealed a low parathyroid hormone level, excluding the possibility of primary hyperparathyroidism, and a negative bone survey, precluding metastatic bone disease. The patient's hypercalcemia was believed to emanate from the humoral secretion of a parathyroid hormone-related peptide, which was found to be elevated, and was abated with conservative management while her cancer was being treated with chemotherapy. The details of this rarely documented presentation, which can easily be mistaken for hepatic encephalopathy, are provided.

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“…The reported incidence of primary hepatic tumors with hypercalcemia ranges from 1.5% to 40% (1,2). The patients with metastasis may or may not have been included in these studies, which would account for the wide variation.…”

Section: Introductionmentioning

confidence: 99%

Severe Hypercalcemia Associated with Hepatocellular Carcinoma Secreting Intact Parathyroid Hormone: A Case Report

et al. 2011

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Here we describe a 73-year-old woman with hypercalcemia caused by a hepatocellular carcinoma (HCC) secreting intact parathyroid hormone (iPTH). Serum tumor markers and dynamic CT findings indicated a diagnosis of HCC. The source of the elevated serum iPTH was not obvious. Transarterial chemoembolization (TACE) was effective against the HCC, and the serum iPTH level fell to within the normal range, suggesting a correlation between the carcinoma and the iPTH. About 2 months later, the tumor had grown and the serum calcium level increased leading to physical deterioration and death. This clinical course suggested that HCC can ectopically secrete iPTH.

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Hepatic arterial embolization for malignant hypercalcemia in hepatocellular carcinoma

Cited by 14 publications

References 13 publications

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

Epidemiology and Prognosis of Paraneoplastic Syndromes in Hepatocellular Carcinoma

Severe Hypercalcemia as an Initial Presenting Manifestation of Hepatocellular Carcinoma

Severe Hypercalcemia Associated with Hepatocellular Carcinoma Secreting Intact Parathyroid Hormone: A Case Report

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