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Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1965 Feb 13;92(7):317–324.

Carcinoma of Lung with Adrenal Hyperfunction and Hypercalcemia Treated by Parathyroidectomy

M Henry Gault, T Douglas Kinsella
PMCID: PMC1928099  PMID: 14243867

Abstract

A case of severe hypercalcemia secondary to carcinoma of the lung is described in which hypokalemic alkalosis, renal failure and pancreatitis were also present. The relative importance of the few bone metastases found at autopsy is considered, and a probable endocrine-like effect of the tumour in the development of the hypercalcemia is postulated. Treatment of the hypercalcemia included administration of corticosteroids and disodium EDTA, peritoneal dialysis and subtotal parathyroidectomy; the most effective of these was peritoneal dialysis. Subtotal parathyroidectomy failed to produce a further decrease in serum calcium values. The occurrence of hypokalemic alkalosis in the presence of increased adrenocortical function and its relationship to the carcinoma of the lung are discussed. The possibility that this neoplasm produced two factors which caused systemic effects ordinarily associated with the function of endocrine glands must be considered.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BURNS R. O., HENDERSON L. W., HAGER E. B., MERRILL J. P. Peritoneal dialysis. Clinical experience. N Engl J Med. 1962 Nov 22;267:1060–1066. doi: 10.1056/NEJM196211222672103. [DOI] [PubMed] [Google Scholar]
  2. COST W. S. A mineralocorticoid excess syndrome presumably due to excessive secretions of corticosterone. Lancet. 1963 Feb 16;1(7277):362–363. doi: 10.1016/s0140-6736(63)91386-2. [DOI] [PubMed] [Google Scholar]
  3. EPSTEIN F. H. Hypercalcemia and renal function. Med Bull (Ann Arbor) 1960 Aug;26:266–270. [PubMed] [Google Scholar]
  4. FERRIS T., KASHGARIAN M., LEVITIN H., BRANDT I., EPSTEIN F. H. Renal tubular acidosis and renal potassium wasting acquired as a result of hypercalcemic nephropathy. N Engl J Med. 1961 Nov 9;265:924–928. doi: 10.1056/NEJM196111092651902. [DOI] [PubMed] [Google Scholar]
  5. FOREMAN H., FINNEGAN C., LUSHBAUGH C. C. Nephrotoxic hazard from uncontrolled edathamil calcium-disodium therapy. J Am Med Assoc. 1956 Mar 24;160(12):1042–1046. doi: 10.1001/jama.1956.02960470038010. [DOI] [PubMed] [Google Scholar]
  6. GELLHORN A., PLIMPTON C. H. Hypercalcemia in malignant disease without evidence of bone destruction. Am J Med. 1956 Nov;21(5):750–759. [PubMed] [Google Scholar]
  7. HARRISON M. T., MONTGOMERY D. A., RAMSEY A. S., ROBERTSON J. H., WELBOURN R. B. Cushing's syndrome with carcinoma of bronchus and with features suggesting carcinoid tumour. Lancet. 1957 Jan 5;272(6958):23–25. doi: 10.1016/s0140-6736(57)92437-6. [DOI] [PubMed] [Google Scholar]
  8. HILLS A. G., WOEBER K. A. The syndrome of intrathoracic neoplasia with bilateral hyperfunction of the adrenal cortex. Ann Intern Med. 1961 Jun;54:1295–1300. doi: 10.7326/0003-4819-54-6-1295. [DOI] [PubMed] [Google Scholar]
  9. HYMES A. C., DOE R. P. Adrenal function in cancer of the lung, with and without Cushing's syndrome. Am J Med. 1962 Sep;33:398–407. doi: 10.1016/0002-9343(62)90236-x. [DOI] [PubMed] [Google Scholar]
  10. ITTRICH G. [Studies on the extraction of red Kober dyes by organic solvents for the determination of urinary estrogens]. Acta Endocrinol (Copenh) 1960 Sep;35:34–48. [PubMed] [Google Scholar]
  11. KABAKOW B., KING F. H., MINES M. F. Hypercalcemia in Hodgkin's disease. N Engl J Med. 1957 Jan 10;256(2):59–62. doi: 10.1056/NEJM195701102560204. [DOI] [PubMed] [Google Scholar]
  12. LIDDLE G. W., ISLAND D. P., NEY R. L., NICHOLSON W. E., SHIMIZU N. Nonpituitary neoplasms and Cushing's syndrome. Ectopic "adrenocorticotropin" produced by nonpituitary neoplasms as a cause of Cushing's syndrome. Arch Intern Med. 1963 Apr;111:471–475. doi: 10.1001/archinte.1963.03620280071011. [DOI] [PubMed] [Google Scholar]
  13. MASSARO D. J., OWEN J. A., Jr Persistent hypercalcemia associated with bronchogenic carcinoma and primary chiefcell hyperplasia of the parathyroids. Am Rev Respir Dis. 1962 May;85:727–734. doi: 10.1164/arrd.1962.85.5.727. [DOI] [PubMed] [Google Scholar]
  14. MELTZER L. E., PALMON F. P., Jr, PAIK Y. K., CUSTER R. P. Acute pancreatitis secondary to hypercalcemia of multiple myeloma. Ann Intern Med. 1962 Dec;57:1008–1012. doi: 10.7326/0003-4819-57-6-1008. [DOI] [PubMed] [Google Scholar]
  15. MURPHY B. P., ENGELBERG W., PATTEE C. J. Simple method for the determination of plasma corticoids. J Clin Endocrinol Metab. 1963 Mar;23:293–300. doi: 10.1210/jcem-23-3-293. [DOI] [PubMed] [Google Scholar]
  16. MYERS W. P. Hypercalcemia in neoplastic disease. Arch Surg. 1960 Feb;80:308–318. doi: 10.1001/archsurg.1960.01290190128024. [DOI] [PubMed] [Google Scholar]
  17. MYERS W. P. Studies of serum calcium regulation. Adv Intern Med. 1962;11:163–213. [PubMed] [Google Scholar]
  18. NELSON D. H., SAMUELS L. T. A method for the determination of 17-hydroxycorticosteroids in blood; 17-hydroxycorticosterone in the peripheral circulation. J Clin Endocrinol Metab. 1952 May;12(5):519–526. doi: 10.1210/jcem-12-5-519. [DOI] [PubMed] [Google Scholar]
  19. NISHIKAZE O., STAUDINGER H. [Thin-layer chromatographic separation of aldosterone from the urine]. Klin Wochenschr. 1962 Oct 1;40:1014–1014. doi: 10.1007/BF01481347. [DOI] [PubMed] [Google Scholar]
  20. PORTER C. C., SILBER R. H. A quantitative color reaction for cortisone and related 17,21-dihydroxy-20-ketosteroids. J Biol Chem. 1950 Jul;185(1):201–207. [PubMed] [Google Scholar]
  21. REISS E., ALEXANDER F. The tubular reabsorption of phosphate in the differential diagnosis of metabolic bone disease. J Clin Endocrinol Metab. 1959 Oct;19:1212–1222. doi: 10.1210/jcem-19-10-1212. [DOI] [PubMed] [Google Scholar]
  22. SANDERSON P. H. Hypercalcaemia and renal failure in multiple secondary carcinoma of bone: report of a case. Br Med J. 1959 Aug 29;2(5147):275–277. doi: 10.1136/bmj.2.5147.275. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. STIEL M. C., PIPER D. W. Pancreatitis associated with hyperparathyroidism. Report of a case. Am J Dig Dis. 1962 Sep;7:850–856. doi: 10.1007/BF02231921. [DOI] [PubMed] [Google Scholar]
  24. THOMAS W. C., Jr, CONNOR T. B., MORGAN H. G. Diagnostic considerations in hypercalcemia; with a discussion of the various means by which such a state may develop. N Engl J Med. 1959 Mar 19;260(12):591–596. doi: 10.1056/NEJM195903192601205. [DOI] [PubMed] [Google Scholar]
  25. THOMAS W. C., Jr, CONNOR T. B., MORGAN H. G. Some observations on patients with hypercalcemia exemplifying problems in differential diagnosis, especially in hyperparathyroidism. J Lab Clin Med. 1958 Jul;52(1):11–19. [PubMed] [Google Scholar]
  26. VERBANCK M., TOUSSAINT C., KAHN R. J., LAMBERT P. P. [Hypercalcemia and alkalosis without Burnett's syndrome]. J Urol Medicale Chir. 1960 Sep;66:693–702. [PubMed] [Google Scholar]
  27. WARWICK O. H., YENDT E. R., OLIN J. S. The clinical features of hypercalcemia associated with malignant disease. Can Med Assoc J. 1961 Sep 23;85:719–723. [PMC free article] [PubMed] [Google Scholar]
  28. WERK E. E., Jr, SHOLITON L. J., MARNELL R. T. Further studies of adrenocortical function in patients with carcinoma of the lung. Am J Med. 1963 Feb;34:192–212. doi: 10.1016/0002-9343(63)90053-6. [DOI] [PubMed] [Google Scholar]
  29. WRONG O., DAVIES H. E. The excretion of acid in renal disease. Q J Med. 1959 Apr;28(110):259–313. [PubMed] [Google Scholar]

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