Esophageal carcinoma with humoral hypercalcemia and leukocytosis successfully treated by a two-stage operation: Report of a case

We herein report a patient demonstrating esophageal carcinoma with humoral hypercalcemia and leukocytosis. A 56-year-old Japanese man complained of a 2-month history of pyrexia. The radiological and endoscopic findings showed advanced esophageal carcinoma with a giant intraabdominal lymph node metastasis. Preoperative examination suggested that the tumor, consisting of squamous cell carcinoma, produced both parathyroid hormone-related protein and granulocyte colony-stimulating factor. We first performed an extirpation of the giant metastatic tumor to reduce the degree of humoral secretion and to improve his general condition. Thereafter, the hypercalcemia, leukocytosis, and other associated symptoms all improved. As a result, we were then able to safely perform an esophagectomy 2 months later. The patient has been doing well during the 10-month follow-up period, and is presently alive more than 1 year since hypercalcemia and leukocytosis were first observed. This is the first report of esophageal carcinoma with humoral hypercalcemia and leukocytosis that was successfully treated by an operation.