PMC3862645_01
PTH, PO4, and calcium levels for case study.. Notes: Serum PTH, PO4, and Ca levels of a 28-year old, previously healthy patient with suspected ectopic production of PTH from a pancreatic neuroendocrine tumor on admission, following acute management of hypercalcemia and relative to the initiation of chemotherapy treatment.. Abbreviations: PTH, parathyroid hormone; PO4, phosphate; Ca, calcium.
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With shrinkage of the tumor, calcium and PTH levels also decreased (Ca 2.02 mmol/L, PTH 21.2 pmol/L) (Figure 1). Her serum PTH level was increased (48.2 pmol/L), whereas PTHrP levels were within normal limits (7.8 pg/mL, 1-15pg/mL) (Figure 1). After the first cycle, her calcium levels normalized (2.34 mmol/L) and following the second cycle, her PTH level decreased to 16.6 pmol/L (Figure 1).
CT scan of case study patient.. Notes: (A) CT-scan of the abdomen at diagnosis showing pancreatic mass (63.0 mm x 56.9 mm) and hepatic metastases at diagnosis. (B) A CT-scan of the abdomen after second course of chemotherapy showing a regression in the size of the pancreatic mass (47.9 mm x 42.1 mm).. Abbreviation: CT, computed tomography.
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A computed tomography scan (CT-scan) showed a large 63 x 57 mm mass that was inseparable from the pancreas in the lesser sac infiltrating the splenic artery (Figure 2). A repeat CT scan of her abdomen also showed a reduction in the size of the pancreatic mass (49 mm x 42 mm) (Figure 2).