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Hypercalcaemia of malignancy: two primaries in the same patient
Deepshikha Trisal1, Naveen Kumar1, Deepak Sundriyal1
1Department of Medicine, PGIMER, Dr RML Hospital, New Delhi, India.
BMJ Case Reports
|June 26, 2014
Summary
Hypercalcaemia of malignancy (HCM) can have multiple causes. This case highlights metastatic breast cancer and multiple myeloma coexisting in one patient, emphasizing the need for thorough diagnosis.
Area of Science:
- Oncology
- Internal Medicine
- Medical Diagnostics
Background:
- Hypercalcaemia of malignancy (HCM) is a critical oncological emergency.
- Metastatic breast cancer and multiple myeloma are significant contributors to HCM.
- Breast cancer can predispose patients to secondary malignancies, including multiple myeloma.
Observation:
- A patient presented with recurrent HCM over three admissions.
- Initial diagnoses focused on metastatic breast cancer as the cause of HCM.
- Subsequent evaluation revealed a coexisting multiple myeloma.
Findings:
- The case demonstrates that multiple distinct malignancies can simultaneously cause HCM in a single patient.
- Diagnostic delays can occur when considering only a single potential etiology for HCM.
Implications:
- This case underscores the importance of comprehensive diagnostic workups for HCM, considering multiple potential underlying cancers.
- Prompt and accurate diagnosis of all contributing malignant causes is crucial for effective management and improved patient outcomes in HCM.
- Clinicians should maintain a high index of suspicion for coexisting malignancies in patients with recurrent or refractory HCM.
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