A 74-year-old woman has metastatic bone disease on x-ray. Which of the following mediators is least likely to be involved?
A whole host of locally produced hormones and cytokines, as well as ectopically produced hormones, are implicated in local osteoclastic hypercalcemia. Parathormone-related protein is often elevated in malignant hypercalcemia (with or without bony metastases), but ectopic PTH production in malignancy is quite rare.
interleukin-6 (IL-6)
ectopic parathyroid hormone (PTH)
tumor necrosis factor (TNF)
interleukin-1 (IL-1)
Endocrinology