We report the case of a 34 year old male presenting with symptomatic hypercalcemia
due to excessive PTHrP secretion from a pancreatic neuroendocrine carcinoma with extensive
hypervascularization and without any evidence for metastatic disease. In the early
phase of the disease conventional chemotherapy with streptozocin and doxorubicin was
able to control functional activity as well as tumor growth. However, after 2 years
tumor escape was indicated by severe therapy-resistant hypercalcemia. Therapeutic
options were reduced due to the excessive tumor vascularization and the patient died
from his disease after a short period of intensified therapy. The role of PTHrP in
hypercalcemia of malignancy (HHM) and its association with neuroendocrine pancreatic
tumors as well as possible therapeutic options are reviewed.
Neuroendocrine pancreatic tumor - parathyroid hormone-related peptide - humoral hypercalcemia
of malignancy - tumor vascularization