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Hypercalcemia of Malignancy

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1. Malignancy-Related Hypercalcemia in Advanced Solid Tumors: Survival Outcomes (PubMed)

Malignancy-Related Hypercalcemia in Advanced Solid Tumors: Survival Outcomes Purpose Malignancy-related hypercalcemia (MRH) is associated with a dismal prognosis. The widespread use of bisphosphonates (BPs), availability of more effective drugs in cancer treatment, and improvement in supportive care might have attenuated its impact. Patients and Methods To assess overall survival (OS) of patients with MRH in a contemporary setting, we conducted a retrospective analysis of 306 patients (...) with solid cancer hospitalized for symptomatic hypercalcemia. A multivariable Cox proportional hazards regression model was performed to evaluate possible prognostic factors associated with MRH. Results All patients had serum ionized calcium > 5.5 mg/dL or total Ca > 10.5 mg/dL. Median age was 57 years, and the majority had squamous cell carcinoma (62%) and Eastern Cooperative Oncology Group performance status > 1 (96%). Head and neck was the most frequent primary site (28%). Forty-five percent had

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2017 Journal of global oncology

2. Hypercalcemia of Malignancy in Thymic Carcinoma: Evolving Mechanisms of Hypercalcemia and Targeted Therapies (PubMed)

Hypercalcemia of Malignancy in Thymic Carcinoma: Evolving Mechanisms of Hypercalcemia and Targeted Therapies Here we describe, to our knowledge, the first case where an evolution of mechanisms responsible for hypercalcemia occurred in undifferentiated thymic carcinoma and discuss specific management strategies for hypercalcemia of malignancy (HCM). Case Description. We report a 26-year-old male with newly diagnosed undifferentiated thymic carcinoma associated with HCM. Osteolytic metastasis (...) -related hypercalcemia was presumed to be the etiology of hypercalcemia that responded to intravenous hydration and bisphosphonate therapy. Subsequently, refractory hypercalcemia persisted despite the administration of bisphosphonates and denosumab indicative of refractory hypercalcemia. Elevated 1,25-dihydroxyvitamin D was noted from the second admission with hypercalcemia responding to glucocorticoid administration. A subsequent PTHrP was also elevated, further supporting multiple mechanistic

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2017 Case reports in endocrinology

3. Malignant melanoma with indiscoverable skin manifestations presenting with paresis and refractory hypercalcemia: A case report. (PubMed)

Malignant melanoma with indiscoverable skin manifestations presenting with paresis and refractory hypercalcemia: A case report. Malignant melanoma with indiscoverable skin manifestations is unusual and refractory hypercalcemia with high metabolic signal of the rectum as initial manifestation is very rare.We present a case that presented with paresis, nausea, and vomiting.Malignant melanoma with spinal metastasis.The patient underwent posterior decompression, partial tumor resection, bone cement (...) reconstruction, and internal fixation. The patient's hypercalcemia was controlled and muscle strength was partially recovered. The immunohistochemical stainings showed Melan-A (+), HMB45 (+), s-100 (+), Vimentin (+), and AE1/AE3 (-).We emphasize the necessity of screening potential existence of neoplasms for the patients with hypercalcemia. Surgical treatment is still necessary for patients with spinal metastasis.

2019 Medicine

4. Successful stereotactic body radiation therapy for stage I non-small cell lung cancer with malignant hypercalcemia — Case report (PubMed)

Successful stereotactic body radiation therapy for stage I non-small cell lung cancer with malignant hypercalcemia — Case report In patients with lung malignancy, the development of malignant hypercalcemia (MH) carries a dismal prognosis and represents a major therapeutic challenge given that conventional medical treatments have limited durability. Robust and lasting hypercalcemic reversal and symptomatic relief have been documented following surgical tumor resection. Stereotactic body

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2018 Journal of radiosurgery and SBRT

5. Isolated Adrenocorticotropic Hormone Deficiency and Severe Hypercalcemia After Destructive Thyroiditis in a Patient on Nivolumab Therapy With a Malignant Melanoma (PubMed)

Isolated Adrenocorticotropic Hormone Deficiency and Severe Hypercalcemia After Destructive Thyroiditis in a Patient on Nivolumab Therapy With a Malignant Melanoma We describe a 58-year-old man with a malignant melanoma metastasis to the liver. After initiation of nivolumab therapy, he developed destructive thyroiditis and subsequently simultaneous isolated adrenocorticotropic hormone (ACTH) deficiency and severe hypercalcemia. Although isolated ACTH deficiency and hypercalcemia due to nivolumab

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2018 Journal of clinical medicine research

6. Hypercalcemia of malignancy treated with cinacalcet (PubMed)

Hypercalcemia of malignancy treated with cinacalcet Hypercalcemia of malignancy is the most common cause of hypercalcemia in hospitalized patients. It is associated with a poor prognosis, since it reflects an advanced cancer stage. Among all cancer in females, breast cancer is the most common malignancy, and it has the highest prevalence of hypercalcemia. Approximately 70% of patients with breast cancer have bone metastases and 10% of them will have hypercalcemia as a complication at some point (...) in the disease. Herein, we report a 69-year-old female patient with metastatic breast cancer, who developed severe hypercalcemia in the course of her disease and was diagnosed with humoral hypercalcemia of malignancy (HHM). Intense hydration along with corticoisteroids and antiresorptive medication (calcitonin, bisphosphonates and denosumab) were administered to the patient. Despite the above treatment, serum calcium levels remain elevated and calcimimetic cinacalcet was added. Upon discontinuation

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2017 Endocrinology, diabetes & metabolism case reports

7. Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer (PubMed)

Humoral Hypercalcemia of Malignancy with a Parathyroid Hormone-Related Peptide-Secreting Intrahepatic Cholangiocarcinoma Accompanied by a Gastric Cancer Humoral hypercalcemia of malignancy (HHM) is caused by the oversecretion of parathyroid hormone-related peptide (PTHrP) from malignant tumors. Although any tumor may cause HHM, that induced by intrahepatic cholangiocarcinoma (ICC) or gastric cancer (GC) is rare. We report here a 74-year-old male who displayed HHM with both ICC and GC and showed (...) an elevated serum PTHrP level. Treatment of the hypercalcemia with saline, furosemide, elcatonin, and zoledronic acid corrected his serum calcium level and improved symptoms. Because treatment of ICC should precede that of GC, we chose chemotherapy with cisplatin (CDDP) and gemcitabine (GEM). Chemotherapy reduced the size of the ICC and decreased the serum PTHrP level. One year after diagnosis, the patient was alive in the face of a poor prognosis for an ICC that produced PTHrP. Immunohistochemical

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2017 Case reports in endocrinology

8. Prevalence of hypercalcemia of malignancy among pediatric cancer patients in the UK Clinical Practice Research Datalink database (PubMed)

Prevalence of hypercalcemia of malignancy among pediatric cancer patients in the UK Clinical Practice Research Datalink database The reported proportion of cancer patients who experience hypercalcemia of malignancy (HCM) is low, particularly in the pediatric population, ranging between <1% and 5%. HCM can be observed with any type of tumor in children and occurs most commonly with leukemia. While HCM is a potentially fatal condition, the prevalence of HCM is not well understood in pediatric

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2017 Clinical epidemiology

9. Hypercalcemia of Malignancy: An Emergency Medicine Simulation (PubMed)

Hypercalcemia of Malignancy: An Emergency Medicine Simulation Hypercalcemia is a poor prognostic factor associated with malignancy. The signs and symptoms of hypercalcemia that the patients present to the emergency department are vague and often overlap with the general symptoms of cancer itself or the adverse effects of the chemotherapy. Given that the development of hypercalcemia of malignancy can present with imminent danger to the patient and is a treatable condition, emergency physicians (...) should know how to recognize and treat it. It also marks a time at which discussions regarding plans of care should be initiated with the patients. In this report, we describe a simulation case that can be used to train emergency medicine residents to both recognize and treat hypercalcemia of malignancy and to initiate the discussion of goals of care.

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2017 Cureus

10. Hypercalcemia of Malignancy and Colorectal Cancer (PubMed)

Hypercalcemia of Malignancy and Colorectal Cancer Our aim is to describe the association between colorectal cancer (CRC) and humoral hypercalcemia of malignancy (HHM). Causes of hypercalcemia of malignancy include parathyroid hormone-related peptide (PTHrP) secretion, local osteolysis, calcitriol production and ectopic parathyroid hormone (PTH) secretion. Hypercalcemia of malignancy in patients with CRCs is a rare scenario. A patient with anal squamous cell carcinoma was admitted (...) that combined etiologies may be present, particularly in cases of resistant hypercalcemia. Treatment of the underlying malignancy is essential for calcium control.

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2016 World journal of oncology

11. Hypercalcemia of Malignancy

Hypercalcemia of Malignancy Hypercalcemia of Malignancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Hypercalcemia of Malignancy (...) Hypercalcemia of Malignancy Aka: Hypercalcemia of Malignancy , Malignant Hypercalcemia , Humoral Hypercalcemia of Malignancy II. Epidemiology : 10-30% of cancer patients III. Pathophysiology Paraneoplastic syndrome (most common, 80% of cases) Tumor secretes related peptide (PTHrP) Results in increased calcium reabsorption in Other mechanisms Bone Metastases release calcium Local osteolysis by cytokines Cancer may release circulating bone-resorbing cytokines, calcitriol ( ) Rare mechanisms Immobilization

2018 FP Notebook

12. Denosumab is Effective for Controlling Serum Calcium Levels in Patients with Humoral Hypercalcemia of Malignancy Syndrome: A Case Report on Parathyroid Hormone-related Protein-producing Cholangiocarcinoma (PubMed)

Denosumab is Effective for Controlling Serum Calcium Levels in Patients with Humoral Hypercalcemia of Malignancy Syndrome: A Case Report on Parathyroid Hormone-related Protein-producing Cholangiocarcinoma Hypercalcemia resulting in the elevation of serum parathyroid hormone-related protein (PTHrP) and suppression of serum PTH was observed in a patient with advanced cholangiocarcinoma (CCC) and multiple lymph node metastases. We confirmed humoral hypercalcemia of malignancy based on PTHrP (...) -producing CCC. Chemotherapy with gemcitabine and cisplatin could not control the patient's serum PTHrP levels and the patient was affected with bisphosphonate-refractory hypercalcemia. We administered a single dose of denosumab, an anti-receptor activator of nuclear factor-kappaB ligand monoclonal antibody, and the patient's serum calcium levels remained close to the normal range for approximately 3 weeks without additional treatment.

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2016 Internal Medicine

13. Laboratory Endocrine Testing Guidelines: Hypercalcemia

concentration with mild hypercalcemia ? Treat hypercalcemia – mild to moderate elevations of calcium with no need for a detailed investigation in patients with known malignancy, i.e., myeloma or carcinoma of bronchus ? Refer to algortighm (see Appendix A) for diagnostic options PRACTICE POINT Symptoms of hypercalcemia include polyuria, altered mentation, nausea/vomiting and constipation BACKGROUND The estimated incidence of hypercalcemia due to primary hyperparathyroidism and to malignancy are 250 cases per (...) million and 150 cases per million respectively. Overall, the incidence of hypercalcemia is about 0.6%. 1-5 In the outpatient-ambulatory setting, hypercalcemia is usually mild and asymptomatic. Primary hyperparathyroidism is the probable cause i.e. over 90%, in asymptomatic people over age 50 with long-standing mild hypercalcemia. 1,2,6 In contrast, a high proportion of hospitalized patients with hypercalcemia will have an underlying malignancy. Symptoms of hypercalcemia (i.e., polyuria, altered

2014 Toward Optimized Practice

14. Primary Bone Marrow B-Cell Lymphoma Undetected by Multiple Imaging Modalities That Initially Presented with Hypercalcemia (PubMed)

hidden hematologic malignancy. As a result, the pathology of bone marrow confirmed the presence of atypical lymphocytes that stained positive for the CD20 marker, which is consistent with BCL involving the bone marrow.This case highlights the importance of pursuing a thorough workup for rare underlying causes of hypercalcemia when parathyroid-related etiologies can be excluded. (...) Primary Bone Marrow B-Cell Lymphoma Undetected by Multiple Imaging Modalities That Initially Presented with Hypercalcemia We report a rare case of severe hypercalcemia that was ultimately diagnosed as primary bone marrow diffuse large B-cell lymphoma (BCL).A 74-year-old male patient visited our hospital complaining of tenderness and swelling of the left knee caused by supracondylar fracture of the left distal femur. His initial blood tests showed a serum calcium level of 13.9 mg/dL, inorganic

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2018 Case reports in endocrinology

15. Hypercalcemia associated with cosmetic injections: A systematic review. (PubMed)

and bisphosphonates in majority of cases. Surgery was attempted in 2 cases but was unsuccessful. Renal failure was the most common complication (82.35% cases) and 2 patients died.Hypercalcemia from cosmetic injections can be severe and life threatening and can present years after the initial procedure. Cosmetic injection-associated granuloma should be considered a cause of hypercalcemia, especially in middle-aged females presenting with non-PTH-mediated, non-malignant hypercalcemia, which is often associated (...) Hypercalcemia associated with cosmetic injections: A systematic review. Cosmetic injections with silicone and polymethylmethacrylate are not FDA approved for augmentation of body parts such as breast, buttock or legs, but they have been widely used for decades. Cosmetic injections can cause foreign body granulomas and occasionally severe and life-threatening hypercalcemia. We aimed to systematically analyze the published literature on cosmetic injection-associated hypercalcemia.We searched

2018 European Journal of Endocrinology

16. Hypercalcemia as a rare presentation of angioimmunoblastic T cell lymphoma: a case report (PubMed)

Hypercalcemia as a rare presentation of angioimmunoblastic T cell lymphoma: a case report Angioimmunoblastic T cell lymphoma is a rare malignancy, accounting for only 2% of all non-Hodgkin lymphomas, first described in the 1970s and subsequently accepted as a distinct entity in the current World Health Organization classification. Due to the paucity of this disease, there is still no identifiable etiology, no consistent risk factors, and the pathogenesis remains unclear.An 83-year-old Caucasian (...) man presented to an emergency department with palpitations and was found to have atrial fibrillation. During his hospitalization, he was found to have asymptomatic hypercalcemia with corrected calcium of 11.7. Ten days later while in rehabilitation, he started complaining of progressive fatigue and altered mental status was noted. He was found to have a calcium level of 15.5 and was admitted to the intensive care unit for management and further workup. He was found at that time to have

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2018 Journal of medical case reports

17. Ovarian cancer presenting with hypercalcemia: two cases with similar manifestations but different mechanisms (PubMed)

and immunostaining for parathyroid hormone-related protein (PTHrP) verified humoral hypercalcemia of malignancy (HHM). In case two, the high level of parathyroid hormone (PTH) and the scintigraphy scan showing parathyroid gland adenoma confirmed primary hyperparathyroidism-induced hypercalcemia. Both patients received optimal cytoreductive operation and adjuvant chemotherapy but showed different outcomes respectively. This article focused on differential diagnosis of ovarian cancer-associated hypercalcemia (...) Ovarian cancer presenting with hypercalcemia: two cases with similar manifestations but different mechanisms Hypercalcemia presenting in ovarian cancer is uncommon in the clinic. Here, two cases of ovarian epithelial carcinoma that presented with severe hypercalcemia were reported, with a review of the literature. The laboratory findings and stepwise clinical investigations of these two cases differed, indicating distinct underlying causes of hypercalcemia. In case one, the serum levels

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2018 Cancer biology & medicine

18. Hypercalcemia-induced acute kidney injury in a Caucasian female due to radiographically silent systemic sarcoidosis (PubMed)

Hypercalcemia-induced acute kidney injury in a Caucasian female due to radiographically silent systemic sarcoidosis . Sarcoidosis is a rare autoimmune disease resulting in formation of non-necrotizing "non-caseating" granulomas generally in the lung. The disease classically strikes African American females in their fourth and fifth decades. The resulting hypercalcemia is a result of 1-α hydroxylase overexpression in granulomas with increased 1,25-dihydroxy vitamin D levels. This phenomenon can (...) also be observed in mycobacterial and fungal infections that produce granulomas in infected patients. Thus, chronic infectious diseases are part of differential diagnosis of granulomatous processes. We present an elderly Caucasian female who presented with hypercalcemia with serum calcium of 11 - 14 mg/dL and an elevated ionized calcium of 1.4 - 1.5 mmol/L. Initially cholecalciferol supplements were stopped, but hypercalcemia persisted for more than 2 months. 1,25-dihydroxy vitamin D levels were

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2018 Clinical Nephrology. Case Studies

19. Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report (PubMed)

Use of Pamidronate to Treat Hypercalcemia in an Oncology Dialysis Patient: A Case Report BACKGROUND Hypercalcemia is a common complication in the intensive care unit (ICU). It can be a result of diverse etiologies, such as malignancy. In this case, bisphosphonates can serve as an effective therapeutic option. However, bisphosphonates are not safe to use in patients with end stage renal disease. CASE REPORT We report a case of severe hypercalcemia possibly secondary to bone metastasis (...) of calcium and no observed adverse effects. Re-dosing was required at an 8-week interval, with no adverse effects. CONCLUSIONS Pamidronate is a safe option to use in treating hypercalcemia in end-stage renal disease patients on dialysis. This can be especially beneficial in patients with sustained hypercalcemia secondary to malignancy.

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2018 The American journal of case reports

20. Case report: Penile squamous cell carcinoma associated with severe hypercalcemia and high levels of Parathyroid Hormone related Peptide (PTHrP) expressed in metastatic skin tissue. (PubMed)

Case report: Penile squamous cell carcinoma associated with severe hypercalcemia and high levels of Parathyroid Hormone related Peptide (PTHrP) expressed in metastatic skin tissue. It is known that high levels of parathyroid hormone-related protein (PTHrP) correlate with a bad prognostic in malignancies. Here we present a patient with advanced penile cancer (PC) without antecedents of human papillomavirus infections and bone metastases but with severe hypercalcemia. By quantitative polymerase (...) chain reaction, we observed high levels of PTHrP messenger RNA in metastatic cutaneous tissue. This is the first reported case in Argentina of hypercalcemia induced by PTHrP in human PC. Furthermore, the association of PTHrP and this disease through quantitative polymerase chain reaction allows us to consider this molecular technique as a novel tool for diagnosis in patients with PC.Copyright © 2018 Elsevier Inc. All rights reserved.

2018 Urology

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