Severe hypercalcemia associated with uterine leiomyoma in pregnancy.
BACKGROUND
Uterine leiomyomas are the most common pelvic tumor, and a frequent indication of the need for gynecologic surgery. Although usually asymptomatic, life-threatening cases can occur. We present a case of critical hypercalcemia associated with a leiomyoma during pregnancy with the intention of highlighting the endocrinology of leiomyomas, features shared with malignant neoplasms, and the potential for effects on obstetric outcomes.


METHODS
A 32-year-old gravid woman with a large leiomyoma presented at 33 5/7 weeks of gestation with critical hypercalcemia requiring intensive care. Postpartum myomectomy cured her hypercalcemia, which was driven by parathyroid hormone-related protein (PTHrP) produced by the tumor.


CONCLUSIONS
Obstetricians should be aware of the existence of humoral hypercalcemia related to leiomyomas and the potential effects on pregnancy.
From the Departments of Obstetrics and Gynecology and Pathology, Medical University of South Carolina, Charleston, South Carolina.
Edward
E
Tarnawa
Scott
S
Sullivan
Paul
P
Underwood
Mary
M
Richardson
Laura
L
Spruill
D000328:Adult; D002117:Calcitriol / Q000627:therapeutic use; D002118:Calcium / Q000097:blood; D003422:Critical Care; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery*; D007231:Infant, Newborn; D007889:Leiomyoma / Q000150:complications* / Q000473:pathology / Q000601:surgery; D000077268:Pamidronate; D044162:Parathyroid Hormone-Related Protein; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000150:complications* / Q000473:pathology / Q000601:surgery
D004164:Diphosphonates; D044162:Parathyroid Hormone-Related Protein; D002117:Calcitriol; D000077268:Pamidronate; D002118:Calcium
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