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Refractory paraneoplastic hypercalcaemia responding to cinacalcet
  1. Preet Mukesh Shah1,2,
  2. Irum Rasool3 and
  3. Deirdre Maguire2
  1. 1Endocrinology and Diabetes, Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
  2. 2Endocrinology and Diabetes, Harrogate District Hospital, Harrogate, UK
  3. 3Endocrinology and Diabetes, St James's University Hospital, Leeds, UK
  1. Correspondence to Dr Preet Mukesh Shah; drpreetshah{at}


A woman in her late 70s presented with an increased frequency of micturition, suprapubic pain and weight loss. She was found to be having advanced cancer of the urinary bladder, coupled with bilateral hydronephrosis.Whilst undergoing surgical intervention for the latter, she was incidentally found to be having hypercalcaemia. This was found to be paraneoplastic in nature, possibly due to elevated parathyroid hormone related peptide with no evidence of bone metastasis. The histology of the resected tumour revealed squamous and sarcomatoid differentiation. Her hypercalcaemia initially responded to intravenous fluids, and later on zolendronate,but the problem recurred again, with the response to a repeat dose of zolendronate and even denosumab being unsatisfactory. As a last resort cinacalcet was started, and although there was a good response to it, our patient sadly died a few weeks later.

We believe our case to be the first case of hypercalcaemia associated with isolated bladder cancer which showed a successful response to cinacalcet.

  • Endocrine system
  • Calcium and bone
  • Drugs: endocrine system
  • Urological cancer
  • Therapeutic indications

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  • Contributors IR contributed to the case description. PMS and DM contributed to the discussion of the case.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

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