Abnormal bone and parathyroid histology in carcinoma patients with pseudohyperparathyroidism

• Published in: Cancer Vol. 49; no. 7; pp. 1449 - 1455
• Main Authors: Sharp, Charles F., Rude, Robert K., Terry, Roger, Singer, Frederick R.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc., A Wiley Company 01.04.1982
• Subjects: Adult; Aged; Blood Chemical Analysis; Bone and Bones - diagnostic imaging; Bone and Bones - pathology; Bone Resorption; Carcinoma, Squamous Cell - blood; Carcinoma, Squamous Cell - pathology; Cyclic AMP - blood; Cyclic AMP - urine; Humans; Hypercalcemia - blood; Hypercalcemia - etiology; Hypercalcemia - pathology; Hyperparathyroidism - blood; Hyperparathyroidism - pathology; Hyperplasia; Middle Aged; Parathyroid Glands - metabolism; Parathyroid Glands - pathology; Parathyroid Hormone - blood; Prospective Studies; Radionuclide Imaging; Respiratory Tract Neoplasms - blood; Respiratory Tract Neoplasms - pathology; Syndrome
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/1097-0142(19820401)49:7<1449::AID-CNCR2820490723>3.0.CO;2-V

Postmortem bone and parathyroid gland histology in nine hypercalcemic cancer patients without bone metastases was compared to bone and parathyroid histology in ten normocalcemic patients. Parameters of parathyroid function, including serum immunoreactive parathyroid hormone, acid base status, serum phosphate, and nephrogenous cyclic AMP were measured in the hypercalcemic group and compared to normals and to patients with primary hyperparathyroidism. Bone histology in all nine hypercalcemic cancer patients showed increased osteoclastic bone resorption and increased fibrous connective tissue in the bone marrow. Parathyroid glands were of normal size in all nine patients but contained little or no fat, one criterion of parathyroid hyperplasia. In the normocalcemic cancer patients only 2/10 had minimally increased bone resorption while 7/10 had decreased or absent stromal fat in the parathyroid glands. Despite the hyperplastic appearance of the parathyroid glands, serum biochemical parameters in the hypercalcemic cancer patients indicate a state of suppressed parathyroid function suggesting that the osteoclastic bone resorption is related to a humoral substance elaborated by the tumors which is distinct from parathyroid hormone.