Cancer Res Treat.  2013 Jun;45(2):145-149.

Two Cases of Humoral Hypercalcemia of Malignancy in Metastatic Cholangiocarcinoma

• Lim S
• Han J
• Park KH
• Jung WJ
• Lee YK
• Choi A
• Kim YJ
• Lee JC
• Choi HJ

Abstract

Humoral hypercalcemia of malignancy (HHM) is rarely associated with cholangiocarcinoma (CC), and represents dismal prognosis. A 63-year-old male was admitted for evaluation of an intrahepatic mass. He was diagnosed with HHM associated with locally advanced CC. As the tumor responded to the concurrent chemoradiotherapy with capecitabine and cisplatin, serum calcium level was normalized. However, according to the disease progression, he suffered recurrence of HHM and he expired approximately one year after initial diagnosis. A 68-year-old male who presented with abdominal pain was diagnosed with metastatic CC. After the eighth cycle of gemcitabine and cisplatin, progression of the disease was found with HHM. He was treated with the best supportive care, until his demise approximately one month after the diagnosis of HHM. We report on two cases of HHM associated with CC that demonstrate strong correlation between hypercalcemia and disease burden.

Keyword

Hypercalcemia; Cholangiocarcinoma; Parathyroid hormone-related protein

MeSH Terms

Abdominal Pain
Calcium
Chemoradiotherapy
Cholangiocarcinoma
Cisplatin
Deoxycytidine
Disease Progression
Fluorouracil
Humans
Hypercalcemia
Male
Paraneoplastic Syndromes
Parathyroid Hormone-Related Protein
Prognosis
Recurrence
Capecitabine
Calcium
Cisplatin
Deoxycytidine
Fluorouracil
Hypercalcemia
Paraneoplastic Syndromes
Parathyroid Hormone-Related Protein

Figure

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  Fig. 1 (A) Computed tomography (CT) scan at initial diagnosis showing intrahepatic metastases measuring 13 cm and invasion of the Lt. portal vein and hepatic vein. (B) Six months later, follow up CT scan after radiation therapy concurrent with capecitabine plus cisplatin showed marked improvement of tumor status.

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  Fig. 2 Patient progress, including changes in corrected serum calcium level and tumor marker. CEA, carcinoembryonic antigen; CA 19-9, cancer antigen 19-9.

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