Denosumab is Effective for Controlling Serum Calcium Levels in Patients with Humoral Hypercalcemia of Malignancy Syndrome: A Case Report on Parathyroid Hormone-related Protein-producing Cholangiocarcinoma

Intern Med. 2016;55(23):3453-3457. doi: 10.2169/internalmedicine.55.7134. Epub 2016 Dec 1.

Abstract

Hypercalcemia resulting in the elevation of serum parathyroid hormone-related protein (PTHrP) and suppression of serum PTH was observed in a patient with advanced cholangiocarcinoma (CCC) and multiple lymph node metastases. We confirmed humoral hypercalcemia of malignancy based on PTHrP-producing CCC. Chemotherapy with gemcitabine and cisplatin could not control the patient's serum PTHrP levels and the patient was affected with bisphosphonate-refractory hypercalcemia. We administered a single dose of denosumab, an anti-receptor activator of nuclear factor-kappaB ligand monoclonal antibody, and the patient's serum calcium levels remained close to the normal range for approximately 3 weeks without additional treatment.

Publication types

  • Case Reports

MeSH terms

  • Bile Duct Neoplasms / complications
  • Bone Density Conservation Agents / therapeutic use*
  • Calcium / blood
  • Cholangiocarcinoma / complications
  • Denosumab / therapeutic use*
  • Humans
  • Hypercalcemia / blood*
  • Hypercalcemia / drug therapy*
  • Hypercalcemia / etiology
  • Male
  • Middle Aged
  • Paraneoplastic Syndromes / blood*
  • Paraneoplastic Syndromes / drug therapy*
  • Paraneoplastic Syndromes / etiology
  • Parathyroid Hormone-Related Protein / blood
  • Proteins

Substances

  • Bone Density Conservation Agents
  • PTHLH protein, human
  • Parathyroid Hormone-Related Protein
  • Proteins
  • Denosumab
  • Calcium

Supplementary concepts

  • Humoral Hypercalcemia Of Malignancy