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Hypercalcaemia in relapsed medulloblastoma 8 years post-diagnosis; evidence to support PTHrP production by medulloblastoma cells

Lookup NU author(s): Dr Poonam Dharmaraj, Dr Stephen Ball, Dr HC Johnstone, Professor Simon Bailey, Professor Steven Clifford, Dr Juliet Hale, Dr Timothy Cheetham

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Abstract

Background: A 19-year-old male presented with symptomatic hypercalcaemia as the first manifestation of relapsed metastatic medulloblastoma. Management at the time of the initial presentation 8 years earlier was with surgical excision and craniospinal radiotherapy. His biochemistry at the time of relapse and studies of medulloblastoma cell lines provide an insight into the pathogenesis of his hypercalcaemia. Methods: Parathyroid hormone-related protein (PTHrP) was measured by immunoradiometric assay in blood, and in conditioned and control media from three medulloblastoma cell lines following 72 h growth. Results: The histology at initial presentation (11 years of age) and at the time of relapse (with bone marrow infiltration and widespread bony metastases) demonstrated medulloblastoma. Ionised calcium concentrations at relapse were 2.89 mmol/l and serum PTHrP levels were increased at the same time (2.7 pmol/l; normal range: 0.7-1.8 pmol/l). There was evidence of PTHrP production by one cell line (MHH-MED-8A) while results for both other lines tested were below the limit of detection. Conclusions: Relapse 8 years after diagnosis is unusual in medulloblastoma and for this relapse to manifest as hypercalcaemia is also very uncommon. Our investigations suggest that the clinical picture was a reflection of PTHrP production by medulloblastoma cells. Copyright © 2006 S. Karger AG.


Publication metadata

Author(s): Dharmaraj P, Ball S, Johnstone H, Bailey S, Clifford SC, Hale J, Cheetham T

Publication type: Article

Publication status: Published

Journal: Hormone Research

Year: 2006

Volume: 66

Issue: 6

Pages: 268-272

Print publication date: 01/11/2006

ISSN (print): 0301-0163

ISSN (electronic): 1423-0046

URL: http://dx.doi.org/10.1159/000095545

DOI: 10.1159/000095545

PubMed id: 16946619


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