Calcitriol induced hypercalcemia-a rare phenomenon in lung cancer:A case report  

作　　者：Amulya Prakash Farhan Khalid Ahmad Alalwan Husam Bader Doantrang Du Trishala Meghal 

机构地区：[1]Department of Internal Medicine,Haywood Regional Medical Center,Clyde,NC 28721,United States [2]Department of Internal Medicine,Monmouth Medical Center,Long Branch,NJ 07740,United States [3]Department of Hematology-Oncology,Monmouth Medical Center,Long Branch,NJ 07740,United States

出　　处：《World Journal of Clinical Oncology》2023年第11期544-548,共5页世界临床肿瘤学杂志（英文版）

摘　　要：BACKGROUND Calcitriol-induced hypercalcemia has been rarely reported in cases of lung cancer;however,it is frequently reported in cases of lymphoid malignancy and granulomatous disease.We present a rare case of hypercalcemia associated with squamous cell cancer of the lung with elevated calcitriol level.CASE SUMMARY A 61-year-old Caucasian female with severe hypercalcemia of 15 mg/dL,which led to a new diagnosis of metastatic lung cancer.Since the parathyroid hormonerelated peptide(PTHrP)level was minimally elevated at 2.1 pmol/L,we believe excessive calcitriol production by tumor cells was the underlying mechanism for hypercalcemia.Calcitriol was significantly elevated at 130 pg/mL with a low 25-hydroxyvitamin D level of 25.9 ng/mL and suppressed PTH level of 8 pg/mL.Corticosteroids are generally used to treat calcitriol-induced hypercalcemia,but we successfully treated our patient with bisphosphonate,highlighting the further utility of bisphosphonates in hypercalcemia treatment.CONCLUSION We believe that the underlying cause of hypercalcemia,in this case of metastatic squamous cell lung carcinoma,was elevated calcitriol,which was likely produced by the tumor cells.In addition to PTHrP,calcitriol levels should be included in the workup for hypercalcemia in cases of lung cancer.However,the pathophysiology and prognostic significance of dysregulated calcitriol production in solid tumors remain unclear and warrant further research.Bisphosphonate may be used as a steroid-sparing therapy even in cases of calcitriol-induced hypercalcemia and warrants further investigation.

关 键 词：Hypercalcemia associated malignancy Lung cancer DENOSUMAB CALCITRIOL Vitamin D Case report 

分 类 号：R736.1[医药卫生—肿瘤]