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Dedifferentiated liposarcoma and 1,25 dihydroxyvitamin D-induced paraneoplastic hypercalcaemia
Meher Binte Ali1, Aaron Ciner2
1Internal Medicine, University of Maryland Medical Center, Baltimore, Maryland, USA meher59@hotmail.com.
BMJ Case Reports
|April 14, 2026
Summary
Hypercalcemia of malignancy (HM) in sarcomas is rare. This case highlights a dedifferentiated liposarcoma causing HM through 1,25-dihydroxyvitamin D overproduction, a mechanism rarely seen in sarcoma.
Area of Science:
- Oncology
- Endocrinology
- Metabolic Bone Disease
Background:
- Hypercalcemia of malignancy (HM) is a complex endocrine disorder.
- Common causes include excess parathyroid hormone-related peptide (PTHrP) or osteolysis.
- 1,25-dihydroxyvitamin D (1,25[OH]2D) overproduction is a rare HM mechanism, especially in sarcomas.
Purpose of the Study:
- To report a rare case of HM in a patient with dedifferentiated liposarcoma.
- To investigate the mechanism of HM, specifically 1,25[OH]2D overproduction.
- To review existing literature on HM associated with sarcomas.
Main Methods:
- Case report of a patient with abdominal pain and weakness.
- Diagnostic workup including blood calcium levels and hormonal assays.
- Literature review of sarcoma-associated HM, focusing on 1,25[OH]2D and PTHrP.
Main Results:
- A large multifocal retroperitoneal dedifferentiated liposarcoma was diagnosed.
- Severe hypercalcemia was attributed to 1,25[OH]2D overproduction.
- Treatment with fluids, bisphosphonates, glucocorticoids, and chemotherapy improved symptoms and normalized calcium levels.
Conclusions:
- Dedifferentiated liposarcoma can cause HM via 1,25[OH]2D overproduction.
- This mechanism is exceptionally rare in sarcoma-associated HM.
- The case underscores the importance of considering diverse HM etiologies in sarcoma patients.
