Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review.
Tongue squamous cell carcinoma producing both parathyroid hormone-related protein and granulocyte colony-stimulating factor: a case report and literature review.
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DOI：
10.1186/s12957-016-0918-1
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发表时间：
2016-06-17
影响因子：
3.2
通讯作者：
Nakamura S
中科院分区：
文献类型：
--
作者：
Kaneko N;Kawano S;Matsubara R;Goto Y;Jinno T;Maruse Y;Sakamoto T;Hashiguchi Y;Iida M;Nakamura S
副肿瘤综合征通常由肿瘤源性激素或肽引起代谢紊乱。常见的代谢疾病包括低钠血症、高钙血症、低血糖症和库欣综合征。在此，我们报告了一例非常罕见的舌癌病例，表现为白细胞增多和高钙血症。一位57岁男性因舌鳞状细胞癌（cT 4aN 0 M0，IV期）入住我院。他接受根治性切除术后，术前放化疗，但局部复发检测术后2个月。他表现为明显的白细胞增多和高钙血症，血清粒细胞集落刺激因子（G-CSF）和甲状旁腺相关蛋白（PTHrP）水平升高。因此，患者接受静脉输液、呋塞米、泼尼松龙、依卡宁和帕米膦酸盐治疗。然而，1个月后，患者因远处转移至肺部而死于癌性胸膜炎。免疫组化分析显示PTHrP和G-CSF在癌细胞中呈阳性染色。在这种情况下，认为肿瘤来源的G-CSF和PTHrP引起白细胞增多和高钙血症。
Paraneoplastic syndrome generally results from tumor-derived hormones or peptides that cause metabolic derangements. Common metabolic conditions include hyponatremia, hypercalcemia, hypoglycemia, and Cushing’s syndrome. Herein, we report a very rare case of tongue carcinoma presenting with leukocytosis and hypercalcemia. A 57-year-old man was admitted to our hospital with tongue squamous cell carcinoma (cT4aN0M0, stage IV). He underwent radical resection following preoperative chemoradiotherapy, but locoregional recurrence was detected 2 months after surgery. He presented with marked leukocytosis and hypercalcemia with elevated serum levels of granulocyte colony-stimulating factor (G-CSF) and parathyroid hormone-related protein (PTHrP). He was therefore managed with intravenous fluids, furosemide, prednisolone, elcatonin, and pamidronate. However, the patient died 1 month later of carcinomatous pleuritis following distant metastasis to the lung. Immunohistochemical analyses of the resected specimens revealed positive staining for PTHrP and G-CSF in the cancer cells. In this case, it was considered that tumor-derived G-CSF and PTHrP caused leukocytosis and hypercalcemia.