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Original Article
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Korean J Med. 2007;73(3):905-909.
- 증례 : 구음 장애로 발현된 원발성 간세포암 1예
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박소영&#;박혜원&#;이정아&#;박지원&#;김성준&#;김현규&#;장명국, , , , , ,
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- A case of primary hepatocellular carcinoma that presented with dysarthria
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So Young Park, Hea Won Park, Jung A Lee, Ji Won Park, Sung Jun Kim, Hyun Kyu Kim, Myoung Kuk Jang
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경희대학교 의과대학 순환기내과학교실
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- Abstract
- Paraneoplastic syndrome is not uncommon in primary hepatocellular carcinoma (HCC), and this syndrome includes
hypercholesterolemia, hypoglycemia, hypercalcemia, erythrocytosis and polycythemia. Of them, dysarthria may be a
neurologic manifestation associated with hypercalcemia. A 48-year-old man visited to our neurosurgery department
because of dysarthria. On the past medical history, he was found to be hepatitis B surface antigen positive 10 years ago.
There were no neurologic abnormalities associated with his dysarthria. The laboratory findings showed elevated serum
calcium levels at 14.8 mg/dL (normal range: 8.4-10.2 mg/dL), but the parathyroid hormone (PTH) levels were decreased
to 0.1 pg/mL (normal range: 10-57 pg/mL). Interestingly, PTH-related peptide (PTH-rp) was increased to 3.5 pg/mL
(normal range: <1.3 pg/mL), and PTH-rp might be released from malignancies. Dynamic CT demonstrated a
hypervascular mass 10 cm in diameter with underlying cirrhotic change, and this was suggestive of HCC. We report here
on a case of HBV-associated HCC that presented with dysarthria associated with humoral hypercalcemia according to
the elevated PTH-rp.(Korean J Med 73:S905-S909, 2007)
Keywords :Hepatocellular carcinoma, Paraneoplastic syndrome, Dysarthria
