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J Thorac Cardiovasc Surg 2006;131:923-924
© 2006 The American Association for Thoracic Surgery

Brief Communication

A case of ectopic parathyroid hormone production by a pulmonary neoplasm

Eric S. Weiss, MD a , * , John Doty, MD a , Malcolm V. Brock, MD a , Lloyd Halvorson, MD b , Stephen C. Yang, MD a

a Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, Md
b Fredrick Medical and Pulmonary Center, Fredrick, Md.

Received for publication November 11, 2005; accepted for publication December 9, 2005.

* Address for reprints: Eric S. Weiss, MD, Department of Surgery, The Johns Hopkins Hospital, The Johns Hopkins Medical Institutions, PO Box 110 Tower, Baltimore, MD 21287 (Email: eweiss3@jhmi.edu).

The first 20% of the full text of this article appears below.


Figure 1
Dr E. Weiss


Hypercalcemia is a well-recognized, albeit infrequent, complication of primary bronchogenic carcinoma. In contrast to neoplasms, which produce hypercalcemia by means of bony invasion with osteolysis, the cause of hypercalcemia in bronchogenic carcinoma has convincingly been demonstrated to be humoral in nature and almost exclusively associated with parathyroid hormone–related protein (PTH-rp). By stark contrast, only 3 cases of bronchogenic carcinoma associated with ectopic production of native parathyroid hormone (PTH) have been reported. 1-3 Go Here we describe a rare case of a pulmonary neoplasm producing ectopic PTH. We further report the successful resection and restoration of normocalcemia in our patient. This unique case challenges conventional beliefs regarding the diagnosis and management of humoral hypercalcemia of malignancy.

Clinical Summary

A 71-year-old white woman presented to her community emergency department with lightheadedness, nausea, and difficulty with balance and was noted to have a serum calcium level of 18.8 mg/dL. Chest radiography revealed a right lung radiodensity, further characterized by chest computed tomography as a 2.4 x 2.6-cm mass within the right midlung adjacent to . . . [Full Text of this Article]




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