Refractory hypercalcaemia. Parathyroid adenoma or multiple myeloma?

Area of Science:

• Oncology
• Endocrinology
• Internal Medicine

Background:

• Multiple myeloma is a hematologic malignancy often associated with hypercalcaemia.
• Primary hyperparathyroidism is a common cause of hypercalcaemia.
• The co-occurrence of multiple myeloma and parathyroid adenoma is rare.

Observation:

• A case study describes a patient with multiple myeloma exhibiting persistent hypercalcaemia.
• The hypercalcaemia persisted despite a positive response to standard multiple myeloma treatments.
• Diagnostic investigation revealed a parathyroid adenoma as the source of the elevated calcium levels.

Findings:

• The persistent hypercalcaemia in this multiple myeloma patient was attributed to a coexisting parathyroid adenoma.
• This case underscores the importance of investigating all potential causes of hypercalcaemia in patients with multiple myeloma.
• The findings suggest that multiple myeloma and parathyroid adenoma can coexist, necessitating a thorough diagnostic approach.

Implications:

• Clinicians should maintain a high index of suspicion for secondary causes of hypercalcaemia in multiple myeloma patients.
• This case highlights the need for comprehensive evaluation to identify all contributing factors to hypercalcaemia.
• Recognizing dual etiologies of hypercalcaemia can lead to more effective patient management and improved outcomes.