Mechanisms and treatment of hypercalcemia of malignancy

@article{Clines2011MechanismsAT,
  title={Mechanisms and treatment of hypercalcemia of malignancy},
  author={Gregory A. Clines},
  journal={Current Opinion in Endocrinology \& Diabetes and Obesity},
  year={2011},
  volume={18},
  pages={339–346}
}
  • G. Clines
  • Published 1 December 2011
  • Medicine, Biology
  • Current Opinion in Endocrinology & Diabetes and Obesity
Purpose of review Hypercalcemia of malignancy is a common paraneoplastic syndrome and a frequent complication of advanced breast and lung cancer, and multiple myeloma. The development of this malignancy complication often purports a poor prognosis. Thorough evaluation to establish the cause of hypercalcemia is essential because some patients may actually have undiagnosed primary hyperparathyroidism. Recent findings Production of humoral factors by the primary tumor, collectively known as… 
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In most cases, therapy normalizes calcium levels and allows for palliation or curative therapy of the malignancy, and may include calcitonin and corticosteroids.
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The rare case of a patient with hypercalcemia and diagnosed primary hyperparathyroidism, which was found that the patient also had elevated 1,25-dihydroxyvitamin D and further studies confirmed a large spleen mass that was later confirmed to be a lymphoma, is reported.
Hypercalcemia of Malignancy: A New Twist on an Old Problem.
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Insight into the pathogenesis of hypercalcemia of malignancy has resulted in new and better therapy for an old but difficult clinical problem, particularly with the advent of the potent bisphosphonate zoledronic acid.
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Denosumab provides potentially a new treatment option for bisphosphonate refractory humoral hypercalcemia of malignancy, especially in the presence of high PTHrP and 1,25(OH)2D.
Humoral Hypercalcemia in a Patient with Cholangiocellular Carcinoma – Effective Therapy with Denosumab
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The therapy of the hyperCalcemia with denosumab due to contraindications for other therapies led to an effective and long-standing remission of hypercalcemia in a 65-year-old Caucasian male.
Hypercalcemia in Lung Cancer due to Simultaneously Elevated PTHrP and Ectopic Calcitriol Production: First Case Report
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It is believed that the elevated calcitriol levels in this case were due to a PTHrP-independent mechanism, possibly from either ectopic production of calcitriols in tumor cells or from increased activity of 1-alpha hydroxylase in the same cells.
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Ectopic Cushing's syndrome caused by ectopic ACTH production results in hypokalemia, proximal muscle weakness, easy bruisability, hypertension, diabetes and psychiatric abnormalities including depression and mood disorders.
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