Refractory hypercalcemia of malignancy related to vitamin D
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Hypercalcemia of malignancy (HCM) is a known cancer complication resulting in morbidity and mortality. It is most often mediated by parathyroid hormone related peptide (PTHrP) or direct bone invasion, but may be related to other humoral causes. Most cases of HCM respond to standard therapies such as fluids, loop diuretics, bisphosphonates, calcitonin, denosumab and control of the underlying malignancy.This report describes the case of a 60-year-old woman with metastatic breast cancer and vitamin D toxicity who developed PTHrP driven HCM. The case is a unique example of breast cancer related HCM in the absence of bone metastases. The hypercalcemia was refractory to standard treatments including intravenous bisphosphonates, fluids and calcitonin. Ultimately, the patient responded to denosumab dosed every seven days along with daily intravenous hydration. Response was maintained despite failure to control the underlying malignancy....

http://www.edoriumjournals.com/journal-of-case-reports-and-images-in-oncology/archive/2016-archive/100025Z10MN2016-naeem/100025Z10MN2016-naeem-full-text.php
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