Hypercalcemia of malignancy

Background

1. Causes:
   1. PTHrP release
      1. SCC (particularly of the head and neck), breast renal, endometrial cancer
   2. Local osteolysis
      1. Associated primarily with bone mets
      2. Multiple myeloma, lung, breast cancer
   3. Production of vitamin D analogues
      1. Lymphoma (Hodgkin)

Clinical Features

1. See Hypercalcemia

Work-Up

1. Chem10
2. Ionized Ca
3. CBC
4. LFTs (alk phos, albumin)
5. ECG

Treatment

1. See Hypercalcemia

Disposition

1. Ca <12
   1. Home with f/u if oncology concurs
2. Ca>12
   1. Admit ward
3. ECG changes
   1. Admit telemetry

See Also

• Hypercalcemia

Source

• EM Practice 3/10
• Tintinalli