Introduction: We report two cases of hypercalcemia-hyperleucocytosis paraneoplastic syndrome complicating cutaneous squamous cell carcinoma.
Case reports: The first patient, a 50-year-old man, suffering for hidradenitis suppurativa for the past 20 years, was admitted for squamous cell carcinoma. Laboratory findings showed marked hypercalcemia and hyperleucocytosis. PTHrP serum level was increased. Bone scintigraphy was normal. There was evidence of pulmonary metastasis. Despite treatment the patient died of agranulocytosis. The second patient was a 60-year-old man who presented with several months enlarging left axillary tumour. He has been treated by surgery for a squamous cell carcinoma of the left hand, 6 months ago. Serum calcium and white cell bloods count were elevated. The diagnosis of metastatic lymph node of cutaneous squamous cell carcinoma was confirmed. There was evidence of pulmonary metastasis. Despite chemotherapy the patient died rapidly.
Conclusion: Hypercalcemia-hyperleucocytosis paraneoplastic syndrome is rarely described during the course of cutaneous squamous cell carcinoma. This syndrome seems to be related to hormones or cytokines secretion by the neoplasic cells including PTHrP and G-CSF. Some authors ascribe it a poor prognostic significance.
Copyright 2010. Published by Elsevier SAS.