Hypercalcemia of Malignancy Attributed to Cosecretion of PTH and PTHRP in Lung Adenocarcinoma
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Date
2021-01-19Journal
AACE Clinical Case ReportsPublisher
American Association of Clinical EndocrinologistsType
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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 DHCM, 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