Hypercalcemia of Malignancy

3/20/00 (Del Rio)

Group: Monday Residents

RE: A 54 year old African-American male with a 3-week history of jaundice, itching, and dark urine.

Question: Which tumors are associated with hypercalcemia of malignancy?

Link Directly to Fulltext Article at Science Direct

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Unique Identifier: 97418821

Authors: Mundy GR. Guise TA.

Institution: Department of Medicine/Endocrinology, University of Texas Health Science Center, San Antonio 78284-7877, USA.

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Unique Identifier: 93169581

Authors: Vassilopoulou-Sellin R. Newman BM. Taylor SH. Guinee VF.

Institution: Section of Endocrinology, University of Texas M. D. Anderson Cancer Center, Houston 77030.

Abstract: BACKGROUND. Hypercalcemia is a serious and not infrequent complication of malignant diseases; precise information about the incidence of hypercalcemia is not readily available. The study was designed to determine the incidence of hypercalcemia in patients with cancer. METHODS. Retrospective analysis was done of laboratory data from 7667 patients registered at M.D. Anderson Cancer Center for the first time during 1989 for whom serum calcium levels were determined during the first 2 months after registration. RESULTS. Severe hypercalcemia (serum calcium level of more than 12.0 mg/100 ml) was present in 40 patients (0.52%); it occurred most often in patients with renal cell cancer (1.42%) and non-small cell lung cancer (1.03%). Less frequent diagnoses were multiple myeloma (0.79%), leukemia (0.63%), non-Hodgkin lymphoma (0.26%), and cancer of the gastrointestinal tract (0.20%). Moderate hypercalcemia (calcium levels of 10.8-12.0 mg/100 ml) was present in 48 patients (0.63%); it occurred most often in patients with renal cell cancer (3.30%) and multiple myeloma (2.38%). Less frequent diagnoses were non-small cell lung cancer (0.89%), non-Hodgkin lymphoma (0.79%), leukemia (0.63%), and cancer of the gastrointestinal tract (0.51%). The presence of hypercalcemia was associated with increased frequency of distant metastases, bone metastases, and increased mortality consistent with other studies of the prognostic effect of this complication. CONCLUSIONS. Hypercalcemia may appear as a frequent complication in patients with cancer at some time during the course of their disease, but its incidence is relatively low.