Hypercalcemia of Malignancy: Simultaneous Elevation in Parathyroid Hormone-Related Peptide and 1,25 Dihydroxyvitamin D in Sarcoma

Dong Won Kim, MD; Ann Miller, MD; Andrew Li, MD; Naomi Hardy, MD; Kristi D. Silver, MD

AACE Clinical Case Reports (May 2021)

Hypercalcemia of Malignancy: Simultaneous Elevation in Parathyroid Hormone-Related Peptide and 1,25 Dihydroxyvitamin D in Sarcoma

Dong Won Kim, MD,
Ann Miller, MD,
Andrew Li, MD,
Naomi Hardy, MD,
Kristi D. Silver, MD

Affiliations

Dong Won Kim, MD: Division of General Internal Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Ann Miller, MD: Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Andrew Li, MD: Division of General Internal Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland
Naomi Hardy, MD: Division of Pathology, University of Maryland School of Medicine, Baltimore, Maryland
Kristi D. Silver, MD: Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland; Address correspondence and reprint requests to Dr Kristi D. Silver, University of Maryland School of Medicine, Department of Medicine, Division of Endocrinology, Diabetes and Nutrition, University of Maryland School of Medicine, 670 W. Baltimore Street, Room 4081, Baltimore, MD 21201.

Journal volume & issue: Vol. 7, no. 3
pp. 169 – 173

Abstract

Read online

Objective: Hypercalcemia is a common finding in patients who have an underlying malignancy. Only a few cases of hypercalcemia of malignancy have been linked to more than one mechanism of hypercalcemia. Here, we present a patient with liposarcoma and hypercalcemia of malignancy in the setting of simultaneous elevations in parathyroid hormone-related peptide (PTHrP) and 1,25 dihydroxyvitamin D [1,25(OH)2D] levels. Sarcoma-associated hypercalcemia is a rare disorder. Methods: The patient was an 89-year-old woman with sarcoma-associated hypercalcemia. Multiple mechanisms were uncovered, and treatments were adjusted for them. Literature search for hypercalcemia of malignancy with multiple mechanisms was conducted. Results: This is the first report describing dual mechanisms of sarcoma-associated hypercalcemia and only the fifth report on PTHrP and 1,25(OH)2D simultaneously causing hypercalcemia of malignancy. Conclusion: Based on this finding, we recommend measuring the 1,25(OH)2D levels in conjunction with the PTHrP level in patients with malignancy as this would allow for a more proactive approach to the diagnosis and treatment of hypercalcemia of malignancy.

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

About the journal

Abstract

Keywords