Differential diagnosis

Calcium

Malignancy

Radiology

Internal medicine

Parathyroid hormone

Medicine

Medical diagnosis

Hyperparathyroidism

Primary hyperparathyroidism

Cancer

Pathology

CA A Cancer Journal for Clinicians

Incidentally detected hypercalcemia usually presents in an indolent manner and is most likely caused by primary hyperparathyroidism. In contrast, hypercalcemia in the patient with a history of cancer presents in a wide range of clinical settings and may be severe enough to warrant hospitalization. This form of hypercalcemia is usually secondary to hypercalcemia of malignancy and can be fatal. Hypercalcemia of malignancy is most commonly mediated by tumoral production of parathyroid hormone–related protein or by cytokines activating osteoclast degradation of bone. The initial workup, differential diagnoses, confirmatory laboratory testing, imaging, and medical and surgical management of hypercalcemia are described in the patient with cancer.

Hypercalcemia and cancer: Differential diagnosis and treatment