Paraneoplastic hypercalcemia with adenosquamous carcinoma of the colon

Abstract

Hypercalcemia is a well-known manifestation of paraneoplastic syndromes associated with a variety of malignancies. However, colon cancer has only rarely been associated with hypercalcemia. Here we present the first case of adenosquamous carcinoma of the sigmoid colon in a patient who was found to have hypercalcemia associated with parathyroid hormone-related protein (PTHrP), with no radiological evidence of metastasis to other organs. A 78-year-old woman was admitted to our hospital complaining of lower abdominal pain. Physical examination and computed tomography revealed a tumor, 13 cm in diameter, in the sigmoid colon. Laboratory data showed an elevated serum calcium level (11.2 mg/dl). Primary colostomy was performed. After the primary operation, the patient was found to have hypercalcemia and an elevated PTHrP level. We performed sigmoidectomy, total hysterectomy, and partial urinary bladder resection 1 month after the primary operation, and both PTHrP and calcium levels immediately returned to normal. The histopathologic diagnosis was poorly differentiated adenosquamous carcinoma. The patient died due to tumor recurrence 4 months after the second surgery.

Morphology and Molecular Features of Rare Colorectal Carcinoma Histotypes

“…SCC is associated with ulcerative colitis, chronic colo-cutaneous fistula, schistosomiasis and colonic duplication [67]; ASC can occur in patients with ulcerative colitis [68] and both may cause paraneoplastic hypercalcemia [69,70]. There is no significant difference in sex, age, and ethnicity between SCC/ASC and conventional CRC.…”

Malignancy in Common Variable Immune Deficiency: Report of Two Rare Cases of Gastrointestinal Malignancy and a Review of the Literature

“…It is estimated that there are 72 new cases of these tumors annually in the USA. In general, these tumors are rare [21] but several reports of these tumors have appeared in the literature [21][22][23][24][25][26]. Some patients with this type of tumor can present with paraneoplastic features such as hypercalcemia, while some cases may coexist with polyposis coli and ovarian or endometrial adenocarcinoma [25].…”

Humoral hypercalcemia of malignancy presenting after oncologic surgery

“…5 Sakata's 6 recent report of a case of HHM from a poorly differentiated colonic adenocarcinoma noted 20 prior cases of HHM associated with colonic malignancy. Fujita 7 subsequently reported on a case of HHM associated with an adenosquamous carcinoma of the sigmoid colon, raising the number of previously reported cases in the English literature to 22.…”