Esophageal Cancer Initially Presenting as Severe Paraneoplastic Hypercalcemia Requiring Hemodialysis

Shin Ahn Hye; Min Yun Jong; Bok Lee Yeong; Yu Mi Ko; Jung Eun Lee; Hye Sung Won; Sung Soo Kim; Young Ok Kim

doi:10.4166/kjg.2015.65.6.361

Journal List > Korean J Gastroenterol > v.65(6) > 1007385

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Hye, Jong, Yeong, Ko, Lee, Won, Kim, and Kim: Esophageal Cancer Initially Presenting as Severe Paraneoplastic Hypercalcemia Requiring Hemodialysis

Case Report

Korean J Gastroenterol 2015;65(6):361-365.

Published online: 4 October 2015

DOI: https://doi.org/10.4166/kjg.2015.65.6.361

Esophageal Cancer Initially Presenting as Severe Paraneoplastic Hypercalcemia Requiring Hemodialysis

Shin Ahn Hye, Min Yun Jong, Bok Lee Yeong, Yu Mi Ko, Jung Eun Lee, Hye Sung Won, Sung Soo Kim, Young Ok Kim

Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: Young-Ok Kim, Department of Internal Medicine, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, 271 Cheonbo-ro, Uijeongbu 480-717, Korea. Tel: +82-31-820-3643, Fax: +82-31-847-2719, E-mail: cmckyo@catholic.ac.kr

Received 4 July 2014 Revised 29 December 2014 Accepted 31 December 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Paraneoplastic hypercalcemia without bone metastasis occurs rarely in esophageal cancer. A 75-year-old man was admitted for general weakness and lethargy. Laboratory data showed high serum calcium level (corrected calcium 14.6 mg/dL), low parathyroid hormone level (3.3 pg/mL) and high parathyroid hormone-related peptide level (3.5 pmol/L). Esophagogastroscopy showed a malignant tumor in the esophagus. Histology showed moderately differentiated squamous cell carcinoma. Bone scan showed no evidence of bone metastasis. Since the patient's calcium levels remained high and mental state did not show improvement despite intravenous fluid therapy, diuretics and intravenous bisphosphonate, hemodialysis was started. After hemodialysis treatment, the serum calcium level subsequently normalized and his mental status improved. Herein, we report a rare case of paraneoplastic hypercalcemia in a patient with esophageal cancer.

Keywords: Hypercalcemia, Esophageal neoplasms, Hemodialysis

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Fig. 1.

CT scan shows eccentric wall thickening of lower esophagus and paratracheal node enlargement.

Fig. 2.

Esophagogastroscopy shows an ulcerative mass with bleeding and necrosis on the distal esophagus.

Fig. 3.

Histologic findings shows moderately differentiated squamous cell carcinoma (H&E stain, ×100).

Fig. 4.

Bone scan shows no evidence of bone metastasis.

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