Case report
Hypercalcemia in a patient with cholangiocarcinoma: a case report
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* Corresponding author: Gregorios S Hatzis grhatzis@med.uoa.gr
1 Department of Pathophysiology, National and Kapodistrian University of Athens, Medical School, Laikon General Hospital, Greece
2 Department of Pathology, National and Kapodistrian University of Athens, Medical School, Greece
International Archives of Medicine 2009, 2:35 doi:10.1186/1755-7682-2-35
Published: 30 October 2009Abstract
Background
Humoral hypercalcemia of malignancy is rarely associated with cholangiocarcinoma (CC).
Case report
A 77-year-old man was admitted with confusion. Computer tomography showed a large multinodular mass in the right lobe of the liver and smaller lesions in the right lung. Liver histology confirmed the diagnosis of CC. Elevated calcium levels and suppressed intact parathyroid hormone in the absence of skeletal metastases or parathyroid gland pathology suggested the diagnosis of humoral hypercalcemia of malignancy (HHM). Treatment of hypercalcemia with saline infusion, loop diuretics, biphosphonate and calcitonin was effective in normalizing calcium levels and consciousness state within 48 hours, but a relapse occurred 4 weeks later and the patient succumbed to his disease.
Conclusion
Clinicians should be aware of this rare manifestation of CC as prompt and aggressive correction of hypercalcemia alleviates symptoms and improves patient's quality of life, despite the poor overall prognosis.