A CASE OF ESOPHAGEAL CANCER WITH HYPERCALCEMIA AND LEUKOCYTOSIS

Abstract

A case of esophageal cancer with hypercalcemia and leukocytosis was reported. A 58-year-old man had an esophageal cancer, 3.6 cm in length, in middle thoracic (Im) region of the esophagus, a giant skip metastasis, 8 cm in diameter, in the gastric fundus, and multiple hepatic metastasis. Despite of bone metastasis and infection, serum calcium went up to 7.5 mEq/1 at maximum and leukocyte count rose to 3×104/ml.Serum PTH was rather lowered to 129 pg/ml. After total gastrectomy was carried out because of massive bleeding from the gastric lesion, serum calcium and leukocyte count decreased, and PTH increased. The production of CSF and PTHrP from the tumor was therefore suspected. Following the operation, radio-immuno-chemotherapy was carried out, but serum calcium re-elevated to 7.1 mEq/1 associated with growing of the hepatic metastasis.Though administration of cisplatin and elcitonin lowered the calcium level, the patient died of aspiration pneumonia on postoperative day 55. An autopsy did not disclose parathyroidal hypertrophy or bone metastasis. There were 13 cases of malignant tumor associated with hypercalcemia and leukocytosis for the past 5 years. Though most of them were squamous carcinomas, this case was only one report of esophageal cancer.