Hypercalcemia complicating childhood malignancies.A report of seven cases with some pathophysiological considerations

Abstract

A group of seven children with different malignant processes presenting with hypercalcemia was studied. Bone destruction, diffuse metabolic abnormalities, abnormal acid-base homeostasis and recurrent hypercalcemia characterized these patients. A different mechanism leading to the production of hypercalcemia and/or bone destruction by cancer cells is considered. The results of this report suggest that parathyroid hormone production (P.T.H.) by the parathyroid glands is normal and that ectopic secretion of PTH or PTH-like material is negligible in these cases.

Towards an Integral Therapeutic Protocol for Breast Cancer Based upon the New H+-Centered Anticancer Paradigm of the Late Post-Warburg Era

“…Intermittent high dose PPI also improves MDR in metastatic BC [ 223 ]. Finally, V-ATPase inhibitors, along with other TME alkalizers, like acid-sensing ion channel 3, have been reported to improve lactic acid-mediated bone pain in metastatic disease in different human cancers [ 226 , 227 , 228 , 229 , 230 , 231 , 232 ].…”

A Case of Acute Lymphoblastic Leukemia Presenting as Sever Hypercalcemia

“…Gastrointestinal (nausea, vomiting, anorexia, constipation), neuromuscular (lethargy, fatigue, hypotonia, stupor, coma), and cardiovascular (bradycardia, arrhythmia) symptoms characterize the clinical spectrum of malignant hypercalcemia [4,6]. Hypercalcemia is a well recognized metabolic complication in adults with cancer, occurring in 5-10% of them [2], but is very rare in childhood, with an incidence of 0.4% in pediatric oncology patients [4].…”

“…However, the serum calcium levels normalized only after the beginning of specific chemotherapy. Hypercalcemia represents an emergency in children, and acute leukemia must be considered in its differential diagnosis, even when there are no circulating blasts.Acute lymphoblastic leukemia (ALL) can rarely present with hypercalcemia, osteolytic lesions, and absence of circulating blasts [1] Hypercalcemia complicating malignancy is a frequent complication in adult patients, with an incidence up to 20% [2] Among hematopoietic malignancies, multiple myeloma and T-cell leukemia/lymphoma have a high incidence of this metabolic abnormality; on the other hand, only a few cases of ALL with hypercalcemia have been reported in children [3][4][5][6][7][8].The hypercalcemia associated with ALL can be classified into 2 categories: those without or with bone metastases [5]. The hypercalcemia of the former group is associated with the action of humoral factors, such as…”

“…Acute lymphoblastic leukemia (ALL) can rarely present with hypercalcemia, osteolytic lesions, and absence of circulating blasts [1] Hypercalcemia complicating malignancy is a frequent complication in adult patients, with an incidence up to 20% [2] Among hematopoietic malignancies, multiple myeloma and T-cell leukemia/lymphoma have a high incidence of this metabolic abnormality; on the other hand, only a few cases of ALL with hypercalcemia have been reported in children [3][4][5][6][7][8].…”

Serum biological markers and paraneoplastic syndromes in Wilms tumor

“…With an incidence of approximately lo%, hypercalcemia is common in certain adult cancer patients [43], but is uncommon in childhood tumors. It has been reported in leukemia [44][45][46] and less frequently in rhabdomyosarcoma [47,48], neuroblastoma [49], lymphoma [48,50,5 11, and renal tumors [48,52,53].…”