Abstract
Malignancy-associated hypercalcemia (MAH) is frequently found in an advanced stage in patients with oral cancer. A retrospective review of oral cancer observed between April 1992 and March 2001, at the Tokai University Hospital, Kanagawa, Japan, was conducted. Twenty-six cases of MAH associated with oral cancer were evaluated. Of these, the site of the primary lesion was tongue (19), buccal mucosa (4), gingiva (1), oral floor (1), and soft palate (1). The peak levels of serum calcium ranged from 12.7-18.7mg/dl. The serum parathyroid hormonerelated protein (PTH-rP) concentration was elevated in every patient. Immunohistochemistry of excised tissues from the patients revealed 23 of 26 specimens were positive for PTH-rP. Thus it seems the MAH associated with oral cancers is equivalent to the humoral hypercalcemia of malignancy (HHM). The average survival period from the diagnosis of MAH was 32.7 days in patients administered hypocalcemic agents (bisphosphonate, elcatonin) and only 17.4 days in untreated patients. As an adjunct treatment, the anticancer drug, peplomycin, was given to 12 previously untreated individuals. The results indicate that peplomycin prolonged survival but not to the extent of the 2 other drugs. Peplomycin could be considered to be a hypocalcemic agents especially for very resistant hypercalcemia.
