Hypercalcemia of Malignancy

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Presentation :

Pathophysiology :

• In patients with bone metastases, direct induction of local osteolysis by the tumor cells causes calcium release
  • Cytokines such as tumor necrosis factor and interleukin-1 appear to play an important role by stimulating the differentiation of osteoclast precursors into mature osteoclasts, which then cause increased bone resorption.
  • Multiple myeloma causes the release of osteoclast activating factors, such as lymphotoxin, interleukin-6, hepatocyte growth factor, and RANKL
• Alternatively may be from secretion of parathyroid hormone (PTH)-related protein (PTHrP)
  • The most common cause of hypercalcemia in patients with nonmetastatic solid tumors
  • accounts for up to 80 percent of patients with hypercalcemia of malignancy

Diagnostic Testing:

Treatment :

Prognosis:

References:

• https://www.uptodate.com/contents/etiology-of-hypercalcemia#H5
• https://www.uptodate.com/contents/hypercalcemia-of-malignancy-mechanisms
• https://www.ncbi.nlm.nih.gov/books/NBK482423/