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Rare disease
CASE REPORT
Twist on a classic: vitamin D and hypercalcaemia of malignancy
  1. Juan C Osorio1,
  2. Masha G Jones1,
  3. Nina Schatz-Siemers2,
  4. Stephanie J Tang1
  1. 1Department of Medicine, Cornell University Joan and Sanford I Weill Medical College, New York, USA
  2. 2Department of Pathology, Cornell University Joan and Sanford I Weill Medical College, New York, USA
  1. Correspondence to Dr Stephanie J Tang, sjt9003{at}med.cornell.edu

Summary

Malignancy is the most common cause of hypercalcaemia in the inpatient setting. Most cases are caused by tumour production of parathyroid hormone-related protein and osseous metastases. In less than 1% of cases, hypercalcaemia is driven by increased production of 1,25-dihydroxyvitamin D (1,25(OH)2D), a mechanism most commonly seen in haematological malignancies. Here, we describe a woman with metastatic small cell cervical carcinoma who developed hypercalcaemia secondary to paraneoplastic overproduction of 1,25(OH)2D, a finding that, to our knowledge, has not been previously associated with this cancer. We also review the current cases of solid tumours reported to have this mechanism of hypercalcaemia and the evidence behind multiple therapeutic approaches.

  • endocrine system
  • malignant disease and immunosuppression
  • calcium and bone
  • oncology
  • gynecological cancer

https://doi.org/10.1136/bcr-2017-220819

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    Footnotes

    • Contributors JCO, MJ, SJT: conception and design of the work, or the acquisition, analysis and interpretation of data. JCO, MJ, NS-S, SJT: drafting the work and revising it critically for important intellectual content. Final approval of the version published. Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.