Plasma-Cell Granuloma Producing Calcitriol and Hypercalcemia

doi:10.1059/0003-4819-105-3-379

Plasma-Cell Granuloma Producing Calcitriol and Hypercalcemia

Columbia, Missouri; and Dallas, Texas

Abstract

A teenage boy presented with hypercalcemia and a large intrathoracic mass. Results of an extensive evaluation, including normal findings on parathyroid hormone and urinary 3 , 5-cyclic adenosine monophosphate assays, failed to explain his hypercalcemia. During surgery, a large plasma-cell granuloma of the right middle and lower lobes was resected. Within 2 weeks, serum calcium levels returned to normal. Serum calcitriol (1,25-dihydroxyvitamin D₃) levels were elevated before surgery and decreased to normal afterward, correlating with the serum calcium level. Homogenates of the plasma-cell granuloma synthesized a compound indistinguishable from calcitriol.

Article and Author Information

▸From the Departments of Surgery, Pathology, and Medicine, University of Mis-souri-Columbia Health Sciences Center, Columbia, Missouri; and the Department of Medicine, Southwestern Medical School, Dallas, Texas.
Grant support: by grant R01-AM26253 from the National Institutes of Health.
▸Requests for reprints should be addressed to Mary Alice Helikson, M.D.; Department of Surgery, Room N307A, University of Missouri-Columbia Health Sciences Center; Columbia, MO 65212.