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Hypercalcemia Associated with Malignancy

William A. Fabricius, MD and Jan Cerny, MD, PhD Reviewed 06/2018
 


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, state of hydration, and underlying malignancy.

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

TREATMENT

GENERAL MEASURES

  • Treatment of underlying malignancy

  • Monitor for hypophosphatemia, which is common in and can worsen hypercalcemia. Replace phosphorus PO or by nasogastric tube.

  • Discontinue use ...

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
Goldner W. Cancer-related hypercalcemia. J Oncol Pract.  2016;12(5):426–432. [View Abstract on OvidMedline]
2
Diel IJ, Body JJ, Stopeck AT, et al. The role of denosumab in the preventio...

ADDITIONAL READING

  • Nussbaum SR, Younger J, Vandepol CJ, et al. Single-dose intravenous therapy with pamidronate for the treatment of hypercalcemia of malignancy: comparison of 30-, 60-, and 90-mg dosa...

SEE ALSO

  • Addison Disease; HIV/AIDS; Hyperparathyroidism; Hyperthyroidism; Milk-Alkali Syndrome; Rhabdomyolysis; Sarcoidosis; Tuberculosis

  • Algorithm: Hypercalcemia

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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