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Small cell carcinoma lung presenting as life-threatening hypercalcemia - A rare association.

Khanna A, Periwal P, Talwar D - Lung India (2015 Nov-Dec)

View Article: PubMed Central - PubMed

Affiliation: Metro Centre for Respiratory Diseases, Metro Multi Specialty Hospital, Noida, Uttar Pradesh, India E-mail: doc.khanna@gmail.com.

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Sir, Hypercalcemia is a commonly reported metabolic complication in various malignancies... The most common cancers associated with hypercalcemia include non-small cell lung cancer, breast cancer and multiple myeloma... The patient was resuscitated withintravenous fluids along with frusemide and4 mg of IV Zolendronic acid... The patient was admitted to the ICU and over the next 48 hours the general condition of the patientgraduallyimproved... EBB showed metaplastic bronchial epithelium, and subepithelium showed infiltration by small round cells with hyperchromatic nuclei and extensive crush artifact... These findings were suggestive of small cell carcinoma lung and the final diagnosis wasconfirmed by immunohistochemistry (IHC), which revealed that the tumor tissue was CD56 and synaptophysin positive... The tumor had metastasized to the adrenals and there were multiple lytic lesions in the calvarium, cerviso-dorso-lumbar vertebrae, scapulae, humerus, clavicles, sacrum and femur [Figure 3]... As the general condition of the patient improved, he was started on chemotherapy with cisplatin and etoposide... Hypercalcemia is a very rare and unusual metabolic complication in SCLC patients... There are isolated case reports of PTHrP-mediated and PTH associated hypercalcemia in patients with SCLC... Most patients with hypercalcemia and SCLC seem to have bone or bone marrow involvement... Our patient had hypercalcemia with normal serum phosphorus level thus, ruling out primary hyperparathyroidism as a cause of hypercalcemia... His serum PTH level was suppressed and circulating PTHrPwas absent... Other common causes of hypercalcemia were ruled out... He did not have raised vitamin D levels, associated plasma cell dyscrasias, thyroid abnormalities or any other underlying granulomatous disease.

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Related in: MedlinePlus

CECT chest, showing the tumor mass encasing the right main bronchus and mediastinal lymphadenopathy
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Figure 1: CECT chest, showing the tumor mass encasing the right main bronchus and mediastinal lymphadenopathy

Mentions: A routine chest X-ray was done which revealed right para-hilar prominence. A contrast-enhanced CT (CECT) chest was done subsequently, which revealed a right hilar mass lesion and multiple enlarged mediastinal lymph nodes [Figure 1].


Small cell carcinoma lung presenting as life-threatening hypercalcemia - A rare association.

Khanna A, Periwal P, Talwar D - Lung India (2015 Nov-Dec)

CECT chest, showing the tumor mass encasing the right main bronchus and mediastinal lymphadenopathy
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4663891&req=5

Figure 1: CECT chest, showing the tumor mass encasing the right main bronchus and mediastinal lymphadenopathy
Mentions: A routine chest X-ray was done which revealed right para-hilar prominence. A contrast-enhanced CT (CECT) chest was done subsequently, which revealed a right hilar mass lesion and multiple enlarged mediastinal lymph nodes [Figure 1].

View Article: PubMed Central - PubMed

Affiliation: Metro Centre for Respiratory Diseases, Metro Multi Specialty Hospital, Noida, Uttar Pradesh, India E-mail: doc.khanna@gmail.com.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Sir, Hypercalcemia is a commonly reported metabolic complication in various malignancies... The most common cancers associated with hypercalcemia include non-small cell lung cancer, breast cancer and multiple myeloma... The patient was resuscitated withintravenous fluids along with frusemide and4 mg of IV Zolendronic acid... The patient was admitted to the ICU and over the next 48 hours the general condition of the patientgraduallyimproved... EBB showed metaplastic bronchial epithelium, and subepithelium showed infiltration by small round cells with hyperchromatic nuclei and extensive crush artifact... These findings were suggestive of small cell carcinoma lung and the final diagnosis wasconfirmed by immunohistochemistry (IHC), which revealed that the tumor tissue was CD56 and synaptophysin positive... The tumor had metastasized to the adrenals and there were multiple lytic lesions in the calvarium, cerviso-dorso-lumbar vertebrae, scapulae, humerus, clavicles, sacrum and femur [Figure 3]... As the general condition of the patient improved, he was started on chemotherapy with cisplatin and etoposide... Hypercalcemia is a very rare and unusual metabolic complication in SCLC patients... There are isolated case reports of PTHrP-mediated and PTH associated hypercalcemia in patients with SCLC... Most patients with hypercalcemia and SCLC seem to have bone or bone marrow involvement... Our patient had hypercalcemia with normal serum phosphorus level thus, ruling out primary hyperparathyroidism as a cause of hypercalcemia... His serum PTH level was suppressed and circulating PTHrPwas absent... Other common causes of hypercalcemia were ruled out... He did not have raised vitamin D levels, associated plasma cell dyscrasias, thyroid abnormalities or any other underlying granulomatous disease.

No MeSH data available.


Related in: MedlinePlus