Parathyroid hormone-related peptide producing cholangiocellular carcinoma with a marked psammoma formation

Humoral hypercalcemia caused by parathyroid hormone-related peptide (PTHrP) , associated with cholangiocellular carcinoma (CCC), has rarely been docume nted. There have been no reports of CCC associated with extensive calcifica tion of the tumor with psammoma body formation. A 66-year-old man was admit ted with a large calcified tumor in the liver detected on an abdominal X-ra y An ultrasound-guided fine needle biopsy specimen of the liver tumor showe d evidence of adenocarcinoma. He had hypercalcemia with an elevated PTHrP l evel. The patient: died because of disseminated intravascular coagulation a nd progressive hepatic failure. A postmortem examination revealed a large p oorly differentiated CCC in the liver. Immunohistochemical examination show ed the presence of PTHrP-positive tumor cells. The calcified lesion consist ed of a number of accumulated psammoma bodies. We present a case of PTHrP p roducing CCC with a marked psammoma formation. (C) 2000 Blackwell Science A sia Pry Ltd.