ABSTRACT
Hypercalcemia is a common metabolic complication of malignancy and has been termed hypercalcemia of malignancy (HCM), tumor-induced hypercalcemia, and humoral HCM. Hypercalcemia is a metabolic emergency and the most common paraneoplastic syndrome. Patients with mild hypercalcemia often do not require immediate treatment and focus should be placed on avoidance of aggravating factors. In cases of severe hypercalcemia, aggressive intravenous rehydration with isotonic saline and close monitoring of volume status is the key initial step in treatment. Patients with asymptomatic or mildly symptomatic moderate hypercalcemia may also not require aggressive immediate treatment. The mainstay of treatment is bisphosphonates, which inhibit osteoclastic bone resorption through osteoclastic apoptosis. There have been case reports describing the use of long-acting octreotide in controlling hypercalcemia in patients with neuroendocrine tumor and breast cancer.
