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Hypercalcemia Associated with Malignancy

Chandana Javvaji, MD and Jan Cerny, MD, PhD Reviewed 06/2019
 


BASICS

DESCRIPTION

  • Hypercalcemia associated with malignancy is the most common cause of severe hypercalcemia diagnosed in a hospital setting.

  • Often a very poor prognostic sign

  • Occurs with both solid tumo...

DIAGNOSIS

  • The severity of symptoms depends on calcium level, rapidity of onset of hypercalcemia, and state of hydration.

  • Early nonspecific symptoms often include nausea, vomiting, anorexia, depression,...

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 on OvidMedline]
2
Diel IJ, B...

ADDITIONAL READING

CODES

ICD10

E83.52 Hypercalcemia 

ICD9

275.42 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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