Téma:  Case Studies

Paraneoplastic hypercalcaemia as a serious symptom of cholangioma carcinoma

Ľubomír Tomáš, Ivica Lazúrová, Juraj Bober, Peter Závacký, Miroslav Ferko

Hypercalcaemia in tumor diseases is the most frequent life threatening metabolic disorder. It is usually the result of osteolysis by direct effecting of osseous metastases. It also can be a paraneoplastic syndrome in abnormal secretion of parathyroid hormone- related protein (PTH-rP) from cells of the primary tumor and secondary activation of osteolysis. The authors present the case of a 46-year-old female patient with prolonged dyspeptic distresses and weight loss. Within the diagnostic procedure only one severe laboratory finding was found up - hypercalcaemia. The level of intact parathormone - was under physiologic low level. Imaging examinations showed focal process of the right lobe of the liver and targeted biopsy confirmed the finding of cholangioma adenocarcinoma. Due to inadequate response to conservative therapy of hypercalcaemia the patient had to undergo haemodialysis and consequently right-sided hemihepatectomy resulted in normalizing of calcaemia and clinical symtomatology. Cholangioma carcinoma is known as malignity with bad prognosis. It is rarely linked with paraneoplastic hypercalcaemic syndrome that might be the symptom of malignant disease.

Ročník 2009  Témy časopisu Internal medicine 7 / 2009

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