Author: Rachel Brady, MD
Hypercalcemia of malignancy:
- Hypercalcemia of malignancy can present with lethargy, muscle weakness, hyperreflexia, altered mental status, cardiac dysrhythmias, and even cardiac arrest.
- Treatment is based both on calcium level and symptoms
- Intravenous rehydration is first line treatment
- Other options include steroids, bisphosphonates and calcitonin.
Tumor Lysis Syndrome
- Occurs due to the breakdown of tumor cells after chemotherapy/radiation
- Presents as hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia
- Treatment is very similar to severe hypercalcemia – hydration with crystalloids
- Hyperuricemia can be treated using rasburicase or allopurinol
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Zagzag J, Hu MI, Fisher SB, Perrier ND. Hypercalcemia and cancer: Differential diagnosis and treatment. CA Cancer J Clin. 2018 Sep;68(5):377-386. doi: 10.3322/caac.21489. Epub 2018 Sep 21. Review. PubMed PMID: 30240520.
Summary by Travis Barlock, MS4 | Edited by Erik Verzemnieks, MD