INTRACTABLE HYPERCALCEMIA DUE TO PARATHYROID HORMONE-RELATED PEPTIDE SECRETION BY A CARCINOID-TUMOR

Hypercalcaemia, a common complication of malignancy, may result from e ither the lytic effect of multiple osseous metastases or the effect of tumour-derived humoral factors. Excessive secretion of parathyroid ho rmone-related peptide (PTHrP), a major cause of humoral hypercalcaemia of malignancy, has been incriminated as the cause of hypercalcaemia i n patients with lung, breast, renal, head and neck and, occasionally, haematological malignancies. Carcinoid tumours, while frequently the s ource of ectopic hormone secretion, are infrequently associated with h ypercalcaemia. We report the case of a 59-year-old woman with fulminan t hypercalcaemia due to excessive PTHrP secretion from a hepatic carci noid and we present the change in her serum PTHrP concentrations durin g infusion of a somatostatin analogue.