| Abstract: |
This chapter discusses hypercalcemia of malignancy (HCM), which occurs commonly in patients with many types of cancer. Hypercalcemia almost always arises in the context of advanced cancer, its clinical presentation varying by degree and rapidity of onset. Parathyroid hormone (PTH)-independent HCM is characterized by suppressed PTH and may be mediated through various mechanisms: via humoral HCM, wherein tumors secrete PTH-related peptide (PTHrP); via local osteolytic lesions; and via overproduction of 1,25-dihydroxyvitamin D (calcitriol). More than one mechanism may be operating simultaneously and need to be targeted for treatment, especially in patients who are refractory to standard calcium-lowering treatments. The focus of this chapter is humoral HCM, including its clinical presentation and treatment approaches, as well as rare causes of HCM, HTLV-1/ATLL, and non-parathyroid tumors. Therapy should be directed toward the various drivers of HCM on a case-by-case basis, as clinically feasible. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG. |
