Hipercalcemia Associada ao Câncer: Casos Clínicos (Cancer Associated Hypercalcemia: Clinical Cases)

– A hipercalcemia associada à malignidade é descrita em 10 a 20% dos pacientes com câncer em alguma etapa da doença, e significa mau prognóstico.

– A hipercalcemia é mais comum no carcinoma de células escamosas de pulmão, cabeça e pescoço, carcinoma de células renais, câncer de mama, mieloma múltiplo e linfoma

– A hipercalcemia associada ao câncer é, com frequência, devida à produção tumoral de peptídeos relacionados ao paratormônio (PTHrp), que se liga a receptores de PTH/PTHrp e estimula a reabsorção óssea e inibe a excreção renal de cálcio.

– Os sintomas relacionados ao sistema nervoso central predominam, tais como progressivo declínio da capacidade cognitiva, estupor e coma.

– As alterações na função renal (incapacidade de concentrar a urina acarretando poliúria) e no trato gastrointestinal (anorexia, náuseas e vômitos) corroboram para a desidratação e agravam a hipercalcemia.

– A hipercalcemia causada pelo câncer é comumente classificada em: 1) hipercalcemia osteolítica local, decorrente da intensa reabsorção óssea osteoclástica nas áreas em torno das células malignas na medula óssea; 2) hipercalcemia humoral maligna, causada pela secreção do peptídeo relacionado ao paratormônio (PTHrP) pela neoplasia maligna; 3) hiperparatireoidismo ectópico; 4) produção de 1,25 (OH)2 D pelo tumor.

O controle adequado da hipercalcemia é necessário para dar tempo de o paciente responder ao tratamento antineoplásico.

■ Hypercalcemia and unilateral ovarian mass in a young adult: a case report of small cell ovarian carcinoma

Gregor Vivod, Sebastjan Merlo, Nina Kovačevi

Am J Case Rep.2021; vol 22: e928959-1–e928959-6

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7849373/

■ Hypercalcemia of malignancy in a case of peripheral nerve sheath tumor: elucidating the roles of simultaneous mechanisms

Malini Ganesh, Sanford Bai

AACE Clin Case Rep.2020, vol 6(3): e135–e140

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7282278/

■ Hypercalcemic crisis caused by a parathyroid mass requiring thoracoscopic resection

Rachel C. Kim, Alexandra M. Roch, Thomas J. Birdas et al

AACE Clin Case Rep.2021, vol 7(4): 264–267

https://bmcnephrol.biomedcentral.com/articles/10.1186/s12882-019-1363-5

■ Hypercalcemia of malignancy: simultaneous elevation in parathyroid hormone-related peptide and 1,25 dihydroxyvitamin D in sarcoma

Dong Won Kim, Ann Miller, Andrew Li, et al

Naomi Hardy, Kristi D. Silver

https://www.aaceclinicalcasereports.com/article/S2376-0605(21)00003-1/pdf

■ Hypercalcemia of malignancy attributed to cosecretion of PTH and PTHRPP in lung adenocarcinoma

Jeffrey M. Kroopnick, Ubaldo Martinez-Outschoorn, Madalina Tuluc, Caroline S. Kim

AACE Clin Case Rep.2021, vol 7(3): 200–203

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8165115/

■ Case Report: unmasking hypercalcemia in patients with neuroendocrine neoplasm. Experience from six Italian referral centers

Elisa Giannetta, Franz Sesti, Roberta Modica et al

Front Endocrinol (Lausanne) 2021, vol 12: 665698

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8170398/

■ Hypercalcemia of malignancy in metastatic esophageal squamous cell carcinoma with simultaneous PTHrp and calcitriol overproduction: a case report with literature review

Runbo Song, Yadav Bijay, Sophia H. Rizk, Shanjin Cao

Ann Med Surg (Lond) 2021, vol 68: 102667

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8358632/

■ Primary hyperparathyroidism presenting as a brown tumor with hypercalcemia crisis in a second-trimester pregnant woman: a case report

Yun Xu, Yingying Yu

Medicine (Baltimore) 2021, vol 100(20): e25968.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8137077/

■ Hypercalcemia in small lymphocytic lymphoma with an elevated parathyroid hormone-related peptide associated with early Richter transformation

Ashish Bains, Pedro Covas, Olga Timofeeva, Michael Bromberg

Case Rep Hematol.2021; 2021: 5525721

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8099529/

■ Hypercalcaemia, renal dysfunction, anaemia and bone lesions (CRAB) do not always represent multiple myeloma: diffuse large B cell lymphoma presenting with CRAB symptomas in a 69-year-old man

Hafez Mohammad Ammar Abdullah, Moataz Ellithi, Qazi Waqas et al

BMJ Case Rep.2019; vol 12(8): e229070.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6685385/

■ Calcitriol-mediated hypercalcemia as an immune-related adverse event in a patient receiving nivolumab and ipilimumab for metastatic renal cell carcinoma, case report

Kai Johnson, Majd Issa, Anish Parikh, et al

BMC Urol.2021; vol 21: 51

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8017871/

■ Hypercalcemic crisis caused by a parathyroid mass requiring thoracoscopic resection

Rachel C. Kim, Alexandra M. Roch, Thomas J. Birdas, et al

AACE Clin Case Rep 2021, vol 7(4): 264–267

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8282530/

■ A woman with a 27-year history of hyperparathyroidism and hypercalcemia who was diagnosed with low-grade parathyroid carcinoma

Monika Kaszczewska, Michał Popow, Witold Chudziński et al

Am J Case Rep.2021; vol 22: e930301-1–e930301-8.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7957837/

■ Hypercalcemia an exceptional complication in upper urinary tract urothelial carcinoma

Issam Jandou, Elmehdi Wichou, Adnane Ettanji, et al

J Surg Case Rep.2021, vol 2021(2): rjaa574

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7880700/

■ A case of humoral hypercalcemia of malignancy secondary to hepatocellular carcinoma with fulminant clinical course

Pamela Castro-Camero, Bumsoo Park, Amit Gupta, et al

Spartan Med Res J 2019; vol 4(1): 8983.

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC7746133/

■ Water clear cell ectopic non-iatrogenic giant parathyroid in sternohyoid muscle with thyroid nodule and asymptomatic hypercalcemia due to primary hyperparathyroidism: case report and literature review

Walla Mohamed, Walid El Ansari, Mohamed S. Al Hassan et al

Int J Surg Case Rep.2021, vol 86: 106295

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC8397889/

■ Hipercalcemia grave como forma de apresentação de leucemia linfoblástica aguda em crianças

Martins, Andreia Luís, Moniz, Marta, Nunes, Pedro Sampaio, Abadesso, Clara, Loureiro, Helena Cristina, Duarte, Ximo, Almeida, Helena Isabel

Revista Brasileira de Terapia Intensiva 2015, vol 27 (4): 402-405

https://www.scielo.br/j/rbti/a/4RRkbzMNgPhbyh33PYjxwxH/?lang=pt

■ Hypercalcemia of malignancy

K L Feldener, J Sarno

J Adv Pract Oncol 2018, vol 9 (5): 496-504

https://www.ncbi.nlm.nih.gov/labs/pmc/articles/PMC6505545/

■ A hypercalcemia nas malignidades: aspectos clínicos, diagnósticos e terapêuticos