Severe hypercalcemia as an initial presenting manifestation of hepatocellular carcinoma: DISCUSSION Part 1

The most common causes of hypercalcemia are primary hyperparathyroidism and malignancy. Hypercalcemia of malignancy occurs most commonly with solid tumours, especially squamous cell malignancy of any origin, and breast and renal cell carcinoma. In these situations, a humoral secretion of PTHrP has been implicated as the most likely etiology, while the intact PTH is usually suppressed. Because this condition may occasionally mimic hyperparathyroidism, a PTH level is commonly required for the diagnosis. Other tumours can cause hypercalcemia, namely multiple myeloma, in which direct bone resorption is triggered by a cytokine secreted from myeloma cells, and lymphoma, in which hypercalcemia is believed to be secondary to an osteolytic process or to the formation of 1,25-dihydroxyvitamin D. As yet, metastatic cancer is believed to be the most common cause of hypercalcemia of malignancy. Find most trusted pharmacy that will give you birth control pills in the amounts required without any need for a prescription. You will see that shopping with a place you can already trust over and over again is very affordable and always nice.

The association between hypercalcemia and hepatic malignancy is rare, with a prevalence ranging from 1.5% to 40% in different reports. It was suggested that the inclusion or exclusion of patients with documented metastasis might have accounted for this big variation. Hypercalcemia has been described mainly with hepatocellular carcinoma and cholangiocarcinoma. A distinct histological subtype called ‘sclerosing hepatic carcinoma’ has been strongly linked to hypercalcemia in the absence of bony metastasis.

Category: Hepatocellular carcinoma

Tags: Hepatocellular carcinoma, Hypercalcemia