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Humoral hypercalcaemia of malignancy associated with a gigantic cutaneous squamous cell carcinoma
  1. Dina Elantably1,
  2. Abdul Rahman Al Armashi2,
  3. Faris Hammad3 and
  4. Akram Alkrekshi1
  1. 1Internal Medicine, Metrohealth Medical Center Case Western Reserve University, Cleveland, Ohio, USA
  2. 2Hematology and Oncology, UH Seidman Cancer Center, Cleveland, Ohio, USA
  3. 3Internal Medicine, St Vincent Charity Medical Center, Cleveland, Ohio, USA
  1. Correspondence to Dr Akram Alkrekshi; aalkrekshi{at}


Humoral hypercalcaemia of malignancy is rarely associated with cutaneous squamous cell carcinoma (SCC), and only a few cases have been reported in the medical literature. We present an interesting case of a gigantic cutaneous SCC associated with severe hypercalcaemia.

A man in his mid 80s presented with a rapidly enlarging fungating mass of his scalp for 5 months. Laboratory studies logged severe hypercalcaemia, low intact parathyroid hormone, elevated parathyroid hormone related-peptide and normal 1,25 dihydroxy vitamin D. Skin biopsy revealed moderately differentiated invasive SCC. Further workup was negative for distant skeletal metastases. Severe hypercalcaemia was managed by intravenous fluids, bisphosphonates and calcitonin. A multidisciplinary approach was then made; the patient received radiotherapy and then underwent a successful surgical resection. By presenting this case, we aim to raise physicians’ awareness of the association between cutaneous SCC and hypercalcaemia. Severe hypercalcaemia should be detected early and promptly managed as it could be fatal.

  • calcium and bone
  • skin cancer

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  • Correction notice This article has been corrected since it was published online. Email address of corresponding author was updated to

  • Contributors DE: conceptualisation, writing-original draft, review and editing. ARAA: conceptualisation, review and editing, FH: conceptualisation, review, and editing. AA: conceptualisation, review and editing, and supervision. All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.

  • 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.