Abstract
A patient with hypercalcemia and a right renal tumor was found to have a significantly elevated serum parathyroid hormone (/PTH) concentration as determined by a sensitive radioimmunoassay. This /PTH could not be distinguished from either the bovine PTH standard or /PTH in serum from a patient with a parathyroid adenoma. The right renal venous serum /PTH concentration was significantly higher than the right renal arterial serum /PTH. At surgery, the patient was found to have a metastatic hypernephroma. Following right nephrectomy both the serum /PTH and serum calcium concentrations remained elevated. Terminally, the serum calcium became normal, but serum /PTH remained elevated. Radioimmunoassay of an extract of the primary tumor estimated the concentration of /PTH in the tissue at 20 ng/g. Data is presented demonstrating the specificity and sensitivity of the radioimmunoassay for PTH. The data support the hypothesis that nonendocrine tumors associated with hypercalcemia without osseous metastases secrete a PTH molecule that corresponds to a precursor form of PTH.
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