Humoral hypercalcemia of malignancy in squamous cell carcinoma of the skin: parathyroid hormone--related protein as a cause.
The second most common cause of hypercalcemia is humoral hypercalcemia of malignancy (HHM), a condition associated with increased mortality. Although hypercalcemia is usually seen in squamous cell cancers, only 13 cases have been described in association with squamous cell skin cancer, and only 5 of these had characteristics of HHM. We report a case of hypercalcemia due to squamous cell skin cancer confined to the chest wall in a 67-year-old semi-comatose patient. Aggressive treatment with intravenous fluid hydration, furosemide, and etidronate corrected the hypercalcemia. A thorough workup ruled out bone metastasis and confirmed increased parathyroid-related protein, the hallmark of HHM. After regaining consciousness, the patient refused further therapy and subsequently died.
Cisneros
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G
Department of Internal Medicine, Northeastern Ohio Universities College of Medicine, Affiliated Hospitals at Canton, 44708, USA.
Lara
L F
LF
Crock
R
R
Whittier
F C
FC
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000150:complications*; D017809:Fatal Outcome; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000209:etiology*; D008297:Male; D010257:Paraneoplastic Syndromes / Q000097:blood / Q000209:etiology / Q000628:therapy; D010281:Parathyroid Hormone / Q000097:blood; D044162:Parathyroid Hormone-Related Protein; D011379:Prognosis; D011506:Proteins / Q000032:analysis; D012878:Skin Neoplasms / Q000150:complications*; D016312:Treatment Refusal
C470121:PTHLH protein, human; D010281:Parathyroid Hormone; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins