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      <JournalTitle>Frontiers in Medical Case Reports</JournalTitle>
      <Volume-Issue>Volume 2; Issue 6</Volume-Issue>
      <Season>(Nov-Dec, 2021)</Season>
      <ArticleType>Medical Case Reports</ArticleType>
      <ArticleTitle>Extreme Alpha Fetoprotein Level and Parathyroid Hormone-Related Peptide Paraneoplastic Syndrome: A Unique Case Report of Hepatocellular Carcinoma</ArticleTitle>
      <Abstract>Tumor markers and paraneoplastic hormones are key investigative tools utilized for diagnosis, prognosis and at times response to treatment in patients with suspicion or diagnosis of malignancy. In the setting of hepatocellular carcinoma, the use of alpha fetoprotein for preclinical detection, prognosis and response to treatment has been readily utilized for over 40 years. In combination with ultrasonography, alpha fetoprotein is also used for surveillance. Serum AFP levels &gt;400 ng/mL in a high-risk patient are nearly diagnostic of HCC, with a specificity of &gt;95 percent. Other tumor markers which have been found to be associated with hepatocellular carcinoma include des-gamma-carboxy prothrombin and lens culinaris agglutinin-reactive AFP (AFP-L3), but very few cases report parathyroid hormone related peptide to be associated with this malignancy specifically. We present a rare relationship between hepatocellular carcinoma and parathyroid hormone related peptide in the setting of extreme elevation of alpha fetoprotein at a level above 500,000 ng/mL.</Abstract>
      <Keywords>Hepatitis, Hepatitis C, Hepatocellular carcinoma, Alpha Fetoprotein, PTHrP,AFP,Parathyroid Related Protein</Keywords>
        <Abstract>https://jmedicalcasereports.org/ubijournal-v1copy/journals/abstract.php?article_id=13491&amp;title=Extreme Alpha Fetoprotein Level and Parathyroid Hormone-Related Peptide Paraneoplastic Syndrome: A Unique Case Report of Hepatocellular Carcinoma</Abstract>
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