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Raised plasma parathyroid hormone related peptide in gastric adenocarcinoma

¹ Boston University School of Medicine and Boston Medical Center, Departments of Medicine and Pathology, 80 East Concord Street, Boston,MA 02118, USA

We report a case of humoral hypercalcemia associated with a rapidly growing gastric carcinoma. To our knowledge, this is the first such case of gastric carcinoma reported with raised plasma parathyroid hormone related peptide (PTHrP) and absent bone metastases.

A 69 year old woman presented with fatigue and intermittent sharp epigastric pain for one week. Upper gastrointestinal radiographs and endoscopy demonstrated a necrotic, friable mass in the mid stomach. Biopsy of the mass and a surrounding satellite polypoid lesion showed poorly differentiated adenocarcinoma and gastric adenoma with high grade dysplasia, respectively (fig 1). Four weeks after the first symptoms had arisen the liver edge was palpable 3 cm below the costal margin. Computed tomographic scan of the abdomen demonstrated several hypodense lesions in the liver and aortic adenopathy compatible with metastases. The following results were found: haematocrit, 0.24; white blood cell count, 12.7 x 10⁹/litre; platelets, 460 x . . . [Full text of this article]