A male patient with humoral hypercalcemia of malignancy (HHM) with leukocytosis caused by cutaneous squamous cell carcinoma resulting from recessive dystrophic epidermolysis bullosa

Kohji Miura, Noriko Umegaki, Taichi Kitaoka, Takuo Kubota, Noriyuki Namba, Yuri Etani, Haruhiko Hirai, Shigetoyo Kogaki, Shigeo Nakajima, Yuji Takahashi, Katsuto Tamai, Ichiro Katayama, Keiichi Ozono

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2 Citations (Scopus)

Abstract

Recessive dystrophic epidermolysis bullosa (RDEB) is a severe skin disorder. Although the patients are at risk for cutaneous squamous cell carcinoma (SCC), no case of cutaneous SCC derived from RDEB with humoral hypercalcemia of malignancy (HHM) has been reported. We present the first case report of a male patient with HHM with leukocytosis caused by cutaneous SCC resulting from RDEB. A 20-yr-old Japanese male patient with RDEB; the diagnosis was confirmed by electron microscopic examination, suffered an intractable skin ulcer and hypercalcemia and leukocytosis. PTH-rP, SCC antigen and Granulocyte colony-stimulating factor (G-CSF) levels were elevated. The histological diagnosis of the skin lesion was made well-differentiated SCC. Immunohistochemical staining showed the expression of PTH-rP in atypical tumor cells. For the control of hypercalcemia before an amputation, we used zoledronate safely and could control the serum Ca concentration in the normal range. After the amputation of his right leg including SCC, leukocytosis improved immediately and PTH-rP in blood decreased to the normal range. One month after the amputation, local recurrence of cutaneous SCC and multiple lung metastases were observed. PTH-rP increased gradually associated with hypercalcemia. Although the patient reached an unfortunate turning point about 4 mo after the amputation, we propose that zoledronate is an effective and safe treatment for HHM with cardiorenal complications.

Original languageEnglish
Pages (from-to)65-71
Number of pages7
Journalclinical pediatric endocrinology
Volume20
Issue number3
DOIs
Publication statusPublished - 2011

Keywords

  • G-CSF
  • Hypercalcemia
  • PTH-rP
  • Recessive dystrophic epidermolysis bullosa
  • Squamous cell carcinoma
  • Zoledronate

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology

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    Miura, K., Umegaki, N., Kitaoka, T., Kubota, T., Namba, N., Etani, Y., Hirai, H., Kogaki, S., Nakajima, S., Takahashi, Y., Tamai, K., Katayama, I., & Ozono, K. (2011). A male patient with humoral hypercalcemia of malignancy (HHM) with leukocytosis caused by cutaneous squamous cell carcinoma resulting from recessive dystrophic epidermolysis bullosa. clinical pediatric endocrinology, 20(3), 65-71. https://doi.org/10.1297/cpe.20.65