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.
Department of Internal Medicine, Northeastern Ohio Universities College of Medicine, Affiliated Hospitals at Canton, 44708, USA.
G
G
Cisneros
L F
LF
Lara
R
R
Crock
F C
FC
Whittier
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