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Hormones and Bone Tissue01:17

Hormones and Bone Tissue

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The endocrine system produces and secretes hormones, which interact with the skeletal system. These hormones control bone growth, maintain bone once it is formed, and remodel it.
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Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
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Calcitonin, a vital polypeptide hormone, regulates calcium levels within body fluids. It is released by the parafollicular cells, also known as C cells, situated in the follicular epithelium of the thyroid gland. Calcitonin responds to fluctuations in blood calcium levels and the influence of gastrointestinal hormones like gastrin and cholecystokinin.
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Calcium is not only the most abundant mineral in bone but also the most abundant mineral in the human body. Calcium ions are needed for bone mineralization, tooth health, heart rate regulation and strength of contraction, blood coagulation, the contraction of smooth and skeletal muscle cells, and the regulation of nerve impulse conduction. The average calcium level in the blood is about 10 mg/dL. When the body cannot maintain this level, a person will experience hypo or hypercalcemia.
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The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
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Bone remodeling is a continuous and balanced process of bone resorption by osteoclasts and bone formation by osteoblasts. In adults, it helps maintain bone mass and calcium homeostasis. While mechanical stress can stimulate turnover as part of the normal maintenance and reparative process, several hormones also regulate bone remodeling.
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Under normal conditions, most adult cells remain in a non-proliferative state unless stimulated by internal or external factors to replace lost cells. Abnormal cell proliferation is a condition in which the cell's growth exceeds and is uncoordinated with normal cells. In such situations, cell division persists in the same excessive manner even after cessation of the stimuli, leading to persistent tumors. The tumor arises from the damaged cells that replicate to pass the damage to the...
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Related Experiment Video

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Models of Bone Metastasis
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Hypercalcemia of Malignancy.

Steve Malangone1, Christopher J Campen1

  • 1University of Arizona Cancer Center, Tucson, Arizona; Greenville Health System, Greenville, South Carolina.

Journal of the Advanced Practitioner in Oncology
|September 21, 2016
PubMed
Summary

This case study highlights successful management of hypercalcemia in a neuroendocrine carcinoma patient. Prompt treatment with hydration, furosemide, and zoledronic acid effectively resolved symptoms and stabilized calcium levels.

Area of Science:

  • Oncology
  • Endocrinology
  • Medical Case Study

Background:

  • Neuroendocrine carcinoma can lead to complex metabolic complications.
  • Hypercalcemia is a serious complication of advanced cancers, impacting patient well-being.
  • Effective management strategies are crucial for improving outcomes in these patients.

Purpose of the Study:

  • To present a case of symptomatic hypercalcemia in a patient with metastatic neuroendocrine carcinoma.
  • To illustrate the diagnostic process and treatment interventions for managing hypercalcemia.
  • To demonstrate the efficacy of a multimodal treatment approach in resolving hypercalcemia and its associated symptoms.

Main Methods:

  • A patient with metastatic neuroendocrine carcinoma presented with symptoms of hypercalcemia.

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  • Initial management included intravenous hydration and furosemide.
  • Subsequent treatment involved intravenous zoledronic acid for persistent hypercalcemia.
  • The patient received third-line systemic therapy with capecitabine and monthly zoledronic acid infusions.

    • Main Results:

    • Intravenous hydration and furosemide led to initial improvement in serum calcium levels.
    • Intravenous zoledronic acid administration resulted in rapid normalization of calcium levels and resolution of symptoms.
    • Third-line capecitabine therapy showed excellent radiologic and tumor marker response.
    • Serum calcium levels remained stable within the normal range after zoledronic acid discontinuation.

    Conclusions:

    • Hypercalcemia in neuroendocrine carcinoma is a manageable complication.
    • A combination of hydration, diuretics, and bisphosphonates like zoledronic acid is effective in treating hypercalcemia.
    • Multimodal therapy can lead to significant clinical improvement and disease control in patients with advanced neuroendocrine carcinoma.