A surgical case of lung cancer with poor general status associated with parathyroid hormone-related protein

Toshiko Kamata, Eitetsu Koh, Atsuko Masunaga, Asako Okabayashi, Mizue Hasegawa, Hideki Katsura, Kenzo Hiroshima, Yasuo Sekine


Parathyroid hormone-related protein (PTHrP), which is released in the presence of malignant disease, is associated with hypercalcemia. Complete resection of the tumor in such patients is rarely performed because of their poor general condition. We herein report a case of lung cancer associated with PTHrP in a patient whose condition dramatically improved after surgery. We also review the literature on the benefits of various surgical options. Although only a few cases of complete resection in such patients have been reported, the mental and physical condition of the patients improved postoperatively and the median survival time was longer than 12 months. A poor general status is frequently considered a contraindication for surgery, even in a palliative setting; however, we conclude that resection of lung cancer may lead to improved symptom control and survival when the patient’s condition is induced by hypercalcemia secondary to PTHrP secretion from the tumor.