title: Hypocalcemia as a presentation for multifocal osteosarcoma.
abstract: We report the case of a 16-year-old male with multifocal osteosarcoma presented with symptomatic hypocalcemia. The patient presented signs of hypocalcemia accompanied by generalized bone pain and a femoral mass. Further evaluation revealed secondary hyperparathyroidism, highly elevated alkaline phosphatase levels, and generalized sclerotic and lytic lesions. Biopsy confirmed osteosarcomatosis. Despite aggressive chemotherapy, he died from progressive disease 2 months after diagnosis. The course of disease in this patient suggests that hypocalcemia reflects a poor prognosis.
authors.affiliation: Endocrinology & Metabolism Research Centre, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran. soltania@sina.tums.ac.ir
authors.forename: Akbar
authors.initials: A
authors.lastname: Soltani
authors.forename: Shirin
authors.initials: S
authors.lastname: Hasani-Ranjbar
authors.forename: Alireza
authors.initials: A
authors.lastname: Moayyeri
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D002114:Calcinosis / Q000209:etiology; D018450:Disease Progression; D017809:Fatal Outcome; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000097:blood / Q000209:etiology; D006996:Hypocalcemia / Q000209:etiology*; D008207:Lymphatic Metastasis; D008297:Male; D010014:Osteolysis / Q000209:etiology; D012516:Osteosarcoma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D010026:Osteosclerosis / Q000209:etiology; D010257:Paraneoplastic Syndromes / Q000209:etiology*; D011379:Prognosis