Related Experiment Video
Updated: Oct 20, 2025
09:31
In Vivo, Percutaneous, Needle Based, Optical Coherence Tomography of Renal Masses
Published on: March 30, 2015
9.0K
Hypercalcemia and Renal Mass: A Diagnostically Challenging Case.
Sunita Karki1, Sneha Galiveeti2, Vivien Leung2
1Internal Medicine, BronxCare Health System, Bronx, USA.
Cureus
|September 13, 2021
Summary
This study presents a rare case of severe hypercalcemia in a renal cell carcinoma patient, driven by elevated vitamin D metabolites rather than typical humoral hypercalcemia of malignancy. It emphasizes considering multiple causes for hypercalcemia in cancer patients.
Area of Science:
- Endocrinology
- Oncology
Background:
- Hypercalcemia of malignancy is common, often due to parathyroid hormone-related peptide (PTHrP).
- 1,25-dihydroxyvitamin D [1,25(OH)2D]-mediated hypercalcemia is less frequent, typically seen in lymphoma.
Observation:
- A 77-year-old male with suspected renal cell carcinoma (RCC) presented with severe hypercalcemia (18.7 mg/dL).
- Initial assessment suggested humoral hypercalcemia of malignancy (HHM), but further tests revealed normal parathyroid hormone, low PTHrP, and high 25-hydroxyvitamin D and 1,25(OH)2D levels.
Findings:
- Bisphosphonate therapy was ineffective.
- Corticosteroid treatment led to reduced serum calcium levels, indicating a role for vitamin D metabolites.
Implications:
- This case underscores the importance of a broad differential diagnosis for severe hypercalcemia in cancer patients.
- It highlights the potential for calcitriol-mediated hypercalcemia in renal cell carcinoma, necessitating consideration of vitamin D pathways.
Related Concept Videos
01:30Urinary Tract Calculi III: Medical Management
54
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
54
01:28Chronic Kidney Disease III: Interprofessional Care
142
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
142
01:26Urinary Tract Calculi II: Pathophysiology and Clinical Manifestations
134
Renal calculi, commonly termed kidney stones, are crystalline solid masses that form in the kidneys but can occur at any point within the urinary system, encompassing the kidneys, ureters, bladder, and urethra.The pathophysiology of renal stones involves several key factors: supersaturation of the urine with stone-forming constituents, changes in urine pH, a decrease in urine volume, and the presence of substances that promote or inhibit stone formation.Supersaturation of Urine: This is the...
134
01:28Urinary Tract Calculi V: Nursing Management
76
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
76
01:28Urinary Tract Calculi I: Introduction
138
Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
138
01:24Chronic Kidney Disease II: Clinical Manifestations
171
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
171