A Case of Parathyroid Hormone Related Protein Producing Islet Cell Tumor of the Pancreas

Kazushi Kurozumi, Masaaki Nakahara, Masayuki Tori, Shigeyuki Ueshima, Masahiko Tujimoto* and Kazuyasu Nakao

Department of Surgery and Pathology*, Osaka Police Hospital

We report a case of parathyroid hormone related protein (PTHrP) producing islet cell carcinoma of the pancreas. An asymptomatic 48-year-old man was referred for a liver tumor found in mass screening. CT and angiographic study showed a hypervascular tumor 4 cm in diameter in the pancreas head and multiple liver tumors. A needle biopsy of the liver tumor yielded a diagnosis of islet cell tumor of the pancreas and multiple liver metastases, necessitating pancreatoduodenectomy and partial liver resection. The immunohistochemical strain of PTHrP was positive in carcinoma. Weekly high-dose 5FU administration (total: 36 g of 5FU) via hepatic artery catheter was done. It was initially effective but followed by multiple bone metastases 13 months after surgery. The patient experienced hypercalcemia and acute renal failure, and serum PTHrP was high at 18.1 pmol/L. Hypercalcemia relapsed despite treatment, and the patient died 15 months after surgery.

Key words
islet cell tumor of the pancreas, parathyroid hormone related protein, hypercalcemia

Reprint requests
Kazushi Kurozumi Department of Surgery, National Kure Medical Center
3-1 Aoyamatcho, Kure, 737-0023 JAPAN

Accepted
December 19, 2003

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