Hypercalcemia and primary hepatic tumors
W. A. Oldenburg, J. A. van Heerden, G. W. Sizemore, C. F. Abboud and P. F. Sheedy 2nd
We treated a case of hypercalcemia and primary liver tumor and reviewed a
series of such cases treated at the Mayo Clinic (Rochester, Minn). Primary
tumor of the liver was diagnosed in 192 patients (152 had hepatocellular
carcinomas; 40, cholangiocarcinomas) between 1969 and 1980. Hypercalcemia
of unknown cause was found in eight patients with hepatocellular carcinoma
(5.3%) and seven with cholangiocarcinoma (17.5%). Five hypercalcemic
patients had serum immunoreactive parathyroid hormone values consistent
with ectopic hyperparathyroidism. An additional five patients had high
serum calcium, low phosphate, and low chloride concentrations that met
Lafferty's criteria for pseudohyperparathyroidism. Our results suggest that
hypercalcemia associated with primary hepatic tumors is relatively common,
and incidences vary according to the type of primary tumor. Hypercalcemia
may be controlled when surgical excision of the primary tumor is possible.