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Abstract
A patient with widespread skeletal metastases from a ventricular carcinomadeveloped markedly elevated serum alkaline phosphatase, in ten monthsincreasing from 200 to 3000 U/l. The hyperphosphatasemia preceded roentgenological demonstration of metastases by eight months. The isoenzyme was demonstrated in the serum, ascites, and the tumor extract and had properties not previously described. Removal of metastatic tumor tissue produced a drop in serum alkaline phosphatase. This, together with the biochemical properties and the demonstration of large quantities of the isoenzyme in extraskeletal metastases, strongly point to an ectopic alkaline phosphatase production.