Filter

Refine by subject

Refine by date

—
  • Print
  • Save
  • Print

Diagnosis and Treatment > Signs and Symptoms

You are looking at 1 - 1 of 1 items for :

Clear All
Nikolaos Asonitis National and Kapodistrian University of Athens, First Department of Internal Medicine, Laikon Hospital, School of Medicine, Athens, Greece
Msc Metabolic Bone Diseases, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

Search for other papers by Nikolaos Asonitis in
Google Scholar
PubMed Close
,
Eva Kassi National and Kapodistrian University of Athens, First Department of Internal Medicine, Laikon Hospital, School of Medicine, Athens, Greece
Msc Metabolic Bone Diseases, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece

Search for other papers by Eva Kassi in
Google Scholar
PubMed Close
,
Michalis Kokkinos National and Kapodistrian University of Athens, First Department of Internal Medicine, Laikon Hospital, School of Medicine, Athens, Greece

Search for other papers by Michalis Kokkinos in
Google Scholar
PubMed Close
,
Ilias Giovanopoulos National and Kapodistrian University of Athens, First Department of Internal Medicine, Laikon Hospital, School of Medicine, Athens, Greece

Search for other papers by Ilias Giovanopoulos in
Google Scholar
PubMed Close
,
Foteini Petychaki National and Kapodistrian University of Athens, First Department of Internal Medicine, Laikon Hospital, School of Medicine, Athens, Greece

Search for other papers by Foteini Petychaki in
Google Scholar
PubMed Close
, and
Helen Gogas National and Kapodistrian University of Athens, First Department of Internal Medicine, Laikon Hospital, School of Medicine, Athens, Greece

Search for other papers by Helen Gogas in
Google Scholar
PubMed Close

Summary

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 of cinacalcet, calcium levels were raised and returned back to the normal levels following re-initiation of the calcimimetic. Her calcium level restored to normal, and she was discharged with the following medical treatment: denosumab monthly, and cinacalcet at a titrated dose of 90 mg per day. The patient is followed as an outpatient and 11 months later, her calcium level remained within the normal range.

Learning points:

  • Hypercalcemia of malignancy is the most common cause of hypercalcemia in hospitalized patients.

  • Breast cancer has the highest prevalence of hypercalcemia.

  • The cornerstone of therapy remains the intense hydration and intravenous bisphosphonates (preferably zoledronic acid).

  • In case of persistent hypercalcemia of malignancy, the administration of calcimimetic cinacalcet could be an additional effective therapeutic option.

Taxonomy:
Clinical Overview, Gland/Organ, Bone, Topic, Tumours and neoplasia, Hormone, Calcitonin, PTH, Condition/ Syndrome, Breast cancer, Hypercalcaemia, Hypothyroidism, Patient Demographics, Age, Geriatric, Gender, Female, Ethnicity, White, Country of Treatment, Greece, Diagnosis and Treatment, Signs and Symptoms, Constipation, Malaise, Myasthaenia, Nausea, Polyuria, Skin - texture change, Tachycardia, Vomiting, Xerostomia, Investigation, Alkaline phosphatase, Calcifediol, Calcitriol, Calcium (serum), Creatinine, Electrocardiogram, Magnesium, Phosphate (serum), PTH, Intervention, Chemotherapy, Fluid repletion, Mastectomy, Radiotherapy, Medication, Bisphosphonates, Calcimimetics, Calcitonin, Cinacalcet, Corticosteroids, Denosumab, Furosemide, Glucocorticoids, Hydrocortisone, Methylprednisolone, Saline, Zoledronic acid, Related Disciplines, Oncology, Publication Details, Case Report Type, Novel treatment
DOI:
https://doi.org/10.1530/EDM-17-0118
Volume/Issue:
Volume 2017: Issue 1
Open access