When viewing this topic in a different language, you may notice some differences in the way the content is structured, but it still reflects the latest evidence-based guidance.

Hypercalcemia of malignancy

Last reviewed: 25 Mar 2025
Last updated: 18 Jul 2023

Summary

Definition

History and exam

Key diagnostic factors

  • history of malignancy
Full details

Other diagnostic factors

  • normal physical exam
  • poor skin turgor and/or dry mucous membranes
  • confusion
  • fatigue
  • constipation
  • loss of appetite
  • nausea
  • polyuria
  • polydipsia
  • bone pain
  • use of hypercalcemia-inducing medication
  • stupor
  • coma
Full details

Risk factors

  • nonmetastatic malignancy
  • metastatic skeletal involvement
  • lymphoma
Full details

Investigações diagnósticas

Primeiras investigações a serem solicitadas

  • total serum calcium
  • serum ionized calcium
  • serum albumin
  • comprehensive metabolic panel
  • resting ECG
  • serum intact parathyroid hormone
  • serum parathyroid hormone-related peptide
  • serum phosphorus
  • serum calcitriol (1,25-dihydroxyvitamin D)
  • serum 25-hydroxyvitamin D
Detalhes completos

Investigações a serem consideradas

  • skeletal survey
  • chest x-ray
Detalhes completos

Algoritmo de tratamento

AGUDA

mild hypercalcemia or asymptomatic moderate hypercalcemia

symptomatic moderate or severe hypercalcemia: without advanced kidney disease

symptomatic moderate or severe hypercalcemia: with advanced kidney disease

Colaboradores

Autores

Albert Shieh, MD

Assistant Professor of Medicine

Division of Geriatric Medicine

Department of Medicine

University of California, Los Angeles

Los Angeles

CA

Declarações

AS declares that he has no competing interests.

Dorothy Martinez, MD

Clinical Professor of Medicine

Division of Endocrinology

Department of Medicine

University of California, Los Angeles

Los Angeles

CA

Declarações

DM declares that she has no competing interests.

Revisores

Ken C. Chiu, MD, FACE

Professor

Endocrinology Fellowship Training Program

Department of Clinical Diabetes, Endocrinology, and Metabolism

City of Hope National Medical Center

Duarte

CA

Declarações

KCC declares that he has no competing interests.

Richard Quinton, MD

Consultant and Senior Lecturer

Endocrine Unit

Newcastle University and Royal Victoria Infirmary

Newcastle-upon-Tyne

UK

Declarações

RQ has been reimbursed by Amgen, the manufacturer of Cinacalcet, for attending a conference and for giving an educational seminar (total under £1,200 over past 3 years).

  • Hypercalcemia of malignancy images
  • Diagnósticos diferenciais

    • Primary hyperparathyroidism
    • Hyperthyroidism
    • Adrenal insufficiency
    Mais Diagnósticos diferenciais
  • Diretrizes

    • Cancer guidelines: symptom management. Oncologic emergencies
    • Treatment of hypercalcemia of malignancy in adults: an Endocrine Society clinical practice guideline
    Mais Diretrizes
  • padlock-lockedConectar-se ou assinar para acessar todo o BMJ Best Practice

O uso deste conteúdo está sujeito ao nosso aviso legal