Final Endo: CH 21 - Humoral/hormonal Manifestations of Malignancy

What is an ectopic hormone?
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- Expressed normally by MSCs (mesenchymal stem cells found in bone marrow)
- it is occasionally secreted by cancer cells (breast cancer,
certain types of lung cancer including squamous-cell lung carcinoma)

- causes bone resorption (breakdown of bone to release calcium) and kidney reabsorption in kidneys. (holding onto calcium in kidneys) which both cause an increase in blood calcium levels

- can lead to hypercalcemia

- PTHrP lacks normal feedback inhibition as PTH

- however, PTHrP is less likely than PTH to stimulate 1,25D3 production
What is non-islet cell tumor-induced hypoglycemia?- rare - low blood glucose Causes: - eutopic insulin production by pancreatic islet cell tumors (insulinomas) (more common) - non-islet tumor-derived insulin-like growth factor 2 (IGF2)What is Doege-Potter syndrome?- hypoglycemia due to non-islet tumor-derived insulin-like growth factor 2 (IGF2) - large: slow growing and well differentiated solitary fibrous tumorsWhat is acromegaly?- syndrome caused by increased amounts of GHRH and GH Causes: > primarily due to eutopic production of GH by pituitary adenomas > remainder of cases due to ectopic production of GHRH by well differentiated neuroendocrine tumors (bronchial or pancreatic tumors) - Ectopic GH overproduction is extremely rare - Increased GHRH causes hyperplasia of somatotrophs in the pituitary - elevates GH and IGF1 GHRH-secreting hamartomas, gliomas and gangliocytomas (not Ectopic) Carcinoid tumors (lung, GI, thymus) are most frequent peripheral source of GHRH (>50%) Pheochromocytoma is associated with ectopically GHRH - induced acromegaly Treatments: Surgical resection, somatostatin analogs (multiple receptor subtypes)What does eutopic overproduction of calcitonin result in?Eutopic overproduction of calcitonin occurs in medullary __________ cancer cells. ? Cause: - Neuroendocrine tumors (NETs) of the foregut, are the primary source of ectopic calcitonin secretion