Treatment of hypercalcemia related to polymethylmethacrylate injection: report of three cases

Polymethylmethacrylate is a microsphere-based plastic used in aesthetic procedures. However, it can cause granuloma formation and severe hypercalcemia, often accompanied by renal impairment, which is a significant concern. Despite increasing reports, there is no standardized treatment approach for polymethylmethacrylate-induced hypercalcemia, and its incidence remains underreported. In this study, we present three cases of polymethylmethacrylate users who developed severe hypercalcemia that was resistant to conventional treatments, resulting in deteriorating renal function. These patients achieved symptom control with cinacalcet, a medication primarily used to treat secondary hyperparathyroidism, severe primary hyperparathyroidism, and parathyroid cancer.