Humoral hypercalcemia of malignancy (HHM) is a metabolic phenomenon that
is mediated by the paraneoplastic secretion of parathyroid
hormone-related peptide (PTH-rP). Gynecologic malignant neoplasms
complicated by HHM have been reported for organs such as the uterus,
cervix, ovary, vulva and the vagina. The purpose of our study was to
perform a review of the published cases in the literature and, further,
to identify parameters with effect on outcome. Among 34 women with
gynecologic neoplasms, 22 suffered from ovarian and 6 from uterine
malignancies, while 3 had vulvar and another 3 cervical cancer.
Furthermore, clear cell carcinoma was the predominant histology
associated with PTH-rP expression. A significant correlation was found
between serum calcium and PTH-rP levels. Treatment of hypercalcemia was
successful in all cases; pamidronate was utilized in 8 patients. Ovarian
cancer patients with severe hypercalcemia and high PTH-rP serum levels
had shorter survival compared to their counterparts with mild
hypercalcemia or moderately elevated PTH-rP serum levels, but the
differences were not statistically significant