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    Hypercalcemia of Malignancy Attributed to Cosecretion of PTH and PTHRP in Lung Adenocarcinoma

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    Author
    Kroopnick, Jeffrey M
    Martinez-Outschoorn, Ubaldo
    Tuluc, Madalina
    Kim, Caroline S
    Date
    2021-01-19
    Journal
    AACE Clinical Case Reports
    Publisher
    American Association of Clinical Endocrinologists
    Type
    Article
    
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    Show full item record
    See at
    https://doi.org/10.1016/j.aace.2021.01.003
    Abstract
    Introduction: Hypercalcemia of malignancy (HCM) portends a very poor prognosis, and no established guidelines exist regarding its management. Most instances of HCM are due to local osteolysis or secretion of parathyroid hormone related-peptide, while less than 1% of all cases are due to ectopic secretion of parathyroid hormone. Case report: We present an unusual case of HCM due to proposed cosecretion of both parathyroid hormone and parathyroid hormone-related protein in a 36-year-old man with a poorly differentiated lung adenocarcinoma. The patient's hypercalcemia was refractory to conventional measures, including intravenous bisphosphonate therapy (zoledronic acid), and was improved with administration of denosumab. Conclusion: This is the youngest and first case of hypercalcemia of malignancy attributed to cosecretion of PTH and PTHrP from an adenocarcinoma. In refractory cases of HCM, denosumab is a potential option when other conventional measures are unsuccessful.
    Keyword
    1,25 vitamin D, 1,25-dihydroxy vitamin D
    HCM, hypercalcemia of malignancy
    HD, hospital day
    Hypercalcemia of malignancy
    PTH, parathyroid hormone
    PTHrP, parathyroid hormone-related peptide
    ZA, zoledronic acid
    cosecretion of PTH and PTHrP
    ectopic PTH
    hypercalcemia of malignancy
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/15971
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.aace.2021.01.003
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