Persaud Christine K, Thorneloe Nicholas S, Matthews Zachary K, Gunther Rutger S, Beckman Darrick J
Division of Endocrinology, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
Department of Internal Medicine, Brooke Army Medical Center, Fort Sam Houston, TX 78234, USA.
JCEM Case Rep. 2025 Mar 28;3(5):luaf060. doi: 10.1210/jcemcr/luaf060. eCollection 2025 May.
Hypercalcemia of malignancy (HCM) occurs frequently in advanced stage cancer and can be secondary to many different etiologies. This case illustrates a rare case of dual-mediated PTH and osteolytic HCM in the setting of metastatic endometrial carcinoma. The patient's hypercalcemia was refractory to initial treatment with IV hydration, calcitonin, and zoledronic acid, eventually requiring the addition of denosumab therapy and cinacalcet. After 15 days of treatment, the patient's calcium concentration returned to normal levels. Owing to elevated PTH levels, other etiologies of hypercalcemia were not initially investigated. Bone metastases, which were not observed on admission computed tomography, were incidentally identified on the technetium-99 m sestamibi scan. This case illustrates that although concurrent etiologies of hypercalcemia are uncommon, it is important to evaluate all possible contributing causes, especially in the clinical setting of malignancy.
恶性肿瘤高钙血症（HCM）在晚期癌症中频繁发生，且可能继发于许多不同病因。本病例展示了转移性子宫内膜癌患者中罕见的由甲状旁腺激素（PTH）和溶骨性双重介导的HCM。患者的高钙血症对初始的静脉补液、降钙素和唑来膦酸治疗无效，最终需要加用狄诺塞麦治疗和西那卡塞。治疗15天后，患者的钙浓度恢复至正常水平。由于PTH水平升高，最初未对高钙血症的其他病因进行调查。入院时计算机断层扫描未发现骨转移，而在锝-99m甲氧基异丁基异腈扫描中偶然发现了骨转移。本病例表明，尽管高钙血症的并发病因并不常见，但评估所有可能的促成原因很重要，尤其是在恶性肿瘤的临床背景下。
