oxyntomodulin and Kidney-Neoplasms

It is noted that while a wide variety of syndromes have been associated with hypernephroma in the clinical literature, there is clear understanding of the pathophysiology of these effects only in the cases of the endocrine disorders where direct tumor production of hormone can be demonstrated in vitro. Furthermore, this knowledge has done little to alter the care of patients with the disease, except for indications that indomethacin might be of benefit in some patients with hypercalcemia and that one might consider the use of converting enzyme inhibitors in patients with hypernephroma and hypertension. The overall approach to the disease is still surgical. Resection of the tumor also removes the paraneoplastic syndrome. Persistence or recurrence of a syndrome suggests the continued presence of the neoplasm, with the considerations for prognosis which that fact entails. To that degree, at least, these conditions are useful as tumor markers, but such use is limited because they are inconsistent. Further studies of pathophysiology of paraneoplastic syndromes will lead to better understanding of processes of cell differentiation and regulation, and possibly better ways to manage the patients in which they occur.

Topics: Carcinoma, Renal Cell; Chorionic Gonadotropin; Erythropoietin; Glucagon-Like Peptides; Humans; Hypercalcemia; Kidney Neoplasms; Paraneoplastic Endocrine Syndromes; Paraneoplastic Syndromes; Parathyroid Hormone; Prolactin; Prostaglandins; Renin

Topics: Adenoma; Adrenocorticotropic Hormone; Erythropoietin; Female; Glucagon-Like Peptides; Gonadotropins; Hormones, Ectopic; Humans; Hypercalcemia; Infant; Insulin; Insulin Secretion; Kidney Neoplasms; Male; Middle Aged; Parathyroid Hormone; Parathyroid Neoplasms; Placental Lactogen; Prolactin; Prostaglandins A; Renin

Four hypercalcemic infantile renal tumors were shown to secrete glucagon-like peptides. These unusual tumors were histologically classified as rhabdoid tumors of the kidney (3 cases) and a cellular mesoblastic nephroma (1 case). Elevated G-29 and G-37 glucagon levels were detected in the plasma and tumor extracts as well as in the supernatants of cultured tumor explants. Three of these tumors were heterotransplanted into the nude mice and serially passaged from a mouse to another. The glucagon level decreased in the transplanted tumor extracts with the number of passage.

Topics: Animals; Female; Gastrointestinal Hormones; Glucagon; Glucagon-Like Peptides; Hormones, Ectopic; Humans; Hypercalcemia; Infant; Kidney Neoplasms; Male; Mice; Mice, Nude; Neoplasm Transplantation; Transplantation, Heterologous; Wilms Tumor