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