Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report

<p>Abstract</p> <p>Introduction</p> <p>Hypercalcemia is the major electrolyte abnormality in patients with malignant tumors. It can be due to localized osteolytic hypercalcemia or elaboration of humoral substances such as parathyroid hormone-related protein from tumoral cells. In hematological malignancies, a third mechanism of uncontrolled synthesis and secretion of 1-25(OH)₂D₃from tumoral cells or neighboring macrophages may contribute to the problem. However, hypercalcemia is quite unusual in patients with B-cell non-Hodgkin's lymphoma.</p> <p>Case presentation</p> <p>An 85-year-old Caucasian woman presented with low grade fever, anorexia, abdominal discomfort and fullness in her left abdomen for the last six months. She was mildly anemic and complained of fatigability. She had huge splenomegaly and was hypercalcemic. After correction of her hypercalcemia, she had a splenectomy. Microscopic evaluation revealed a malignant lymphoma. Her immunohistochemistry was positive for leukocyte common antigen, CD20 and parathyroid hormone-related peptide.</p> <p>Conclusion</p> <p>Immunopositivity for parathyroid hormone-related peptide clearly demonstrates that hypersecretion of a parathyroid hormone-like substance from the tumor had led to hypercalcemia in this case. High serum calcium is seen in only seven to eight percent of patients with B-cell non-Hodgkin's lymphoma, apparently due to different mechanisms. Evaluation of serum parathyroid hormone-related protein and 1-25(OH)₂D₃can be helpful in diagnosis and management. It should be noted that presentation with hypercalcemia has a serious impact on prognosis and survival.</p

Efficacy of Taxotere, Thalidomide, and Prednisolone in Patients with Hormone-Resistant Metastatic Prostate Cancer

Purpose: To evaluate the efficacy and safety of combination treatment with thalidomide and taxotere in patients with hormone-resistant prostate cancer.Materials and Methods: This clinical trial was performed on 16 patients with hormone-resistant prostate cancer. Results: Mean age of the participants was 72.7 ± 5.39 years (range, 65 to 85 years). In 94% of patients who received the drug combination, prostate-specific antigen level decreased more than 50%. The mean time to progression was 15 months and mean survival time was 23 months. This combination therapy has some adverse events.Conclusion: Addition of anti-angiogenic agents, such as thalidomide, can improve therapeutic outcome in this group of patients

Comparing Radiotherapy alone with Chemotherapy Radiotherapy in Treatment of Patients with Stage II and III Endometrial Cancer

&quot;nAbstract &quot;nIntroduction: Endometrial cancer is the most common pelvic malignancy in women. Approximately 7,000 women die from this disease every year. Although most patients can be treated with appropriate therapies, there is insufficient data regarding the choice of the best adjuvant therapy after a surgical procedure in advanced endometrial cancer cases. It seems that radiotherapy or chemotherapy alone don&amp;rsquo;t provide good survival. The aim of this study was to compare radiotherapy alone with chemotherapy-radiotherapy in the treatment of patients with stages II and III endometrial cancer. &quot;nMethods: In this study, we selected 34 patients with stages II and III endometrial cancer who had undergone surgery. There were 22 patients in first group who received chemotherapy and 12 patients in second group who received chemotherapy and then radiotherapy with the same dosage as the first group. Mean survival rates and disease free survival rates during a 30-month period were evaluated. &quot;nResults: Local relapse was noted in 7 of the patients in the first group who had undergone radiotherapy alone, while no relapse was noted in the second group (p=0.03). Distant metastasis was observed in one patient from the first group. The disease free survival in first group was 22.4&amp;plusmn; 1.2 months. In the second group, whhad undergone radiotherapy after chemotherapy, no relapse or metastasis was observed. There was no significant difference regarding between the two groups serious adverse effects. &quot;nConclusions: This study showed that radiotherapy after chemotherapy is an effective method of treatment for patients with stages II and III endometrial cancer and is not associated with significant adverse effects. &quot;n&amp;nbsp; &quot;nKey words: Endometrial Cancer, Radiotherapy, Chemotherapy, Averse Effects, Local Relapse, Distant Metastasi

Postpartum Hypercalcemia Secondary to a Neuroendocrine Tumor of Pancreas; a Case Report and Review of Literature

Parathyroid hormone-related protein producing pancreatic neuroendocrine tumors have been infrequently reported. Herein, we report a case of an Iranian woman who had such a tumor during pregnancy, and gave birth to a female neonate with esophago-tracheal fistula and imperforated anus. Hypercalcemia was diagnosed at postpartum because of elevated serum calcium levels in the neonate and neurologic deterioration of the mother. Extensive literature review revealed 42 cases with pancreatic neuroendocrine tumors and hypercalcaemia. The clinical and laboratory findings of such patients are reviewed in this manuscript.<