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Hypercalcemia Associated with Malignancy

Jan Cerny, PhD, MD and Ishan I Bhatia, Bachelor of Arts, Hamilton College Reviewed 04/2024
 


BASICS

DESCRIPTION

  • Hypercalcemia is defined as a serum calcium level greater than the upper limit of normal range, which is 8.5-10.5 mg/dl.

  • Hypercalcemia of malignancy is a frequent metabolic complicati...

DIAGNOSIS

  • Hypercalcemia of malignancy (HCM) can be stratified according to severity, based upon serum calcium (SCa) levels. Mild HCM has SCa <12 mg/dL, moderate HCM has SCa 12-14 mg/dL, and severe ...

TREATMENT

  • Mild hypercalcemia with calcium <12 mg/dL and asymptomatic do not need immediate treatment.

  • Moderate hypercalcemia with calcium between 12 and 14 mg/dL and if it is an acute rise need imme...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Avoid bed rest or immobilization as much as possible. 

Patient Monitoring

Frequent serum calcium and electrolyte determinations; expect relapse. 

PROGNOSIS

Median sur...

REFERENCES

1
Wright  JD, Tergas  AI, Ananth  CV, et al. Quality and outcomes of treatment of hypercalcemia of malignancy. Cancer Invest.  2015;33(8):331-339. [View Abstract...

ADDITIONAL READING

SEE ALSO

Hypercalcemia algorithm 

CODES

ICD10

E83.52 Hypercalcemia 

SNOMED

47709007 Humoral hypercalcemia of malignancy (disorder) 

CLINICAL PEARLS

  • Hypercalcemia of malignancy carries with it a very poor prognosis. Left untreated, the median survival is 2 to 6 weeks.

  • Diagnosis may be difficult unless the patient has a known maligna...

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