Abstract
Abstract
The hypercalcemia of malignancy is a common metabolic complication in some advanced stage tumors and it is defined as a serum calcium rate higher than 10.5 mg/dl. It is present in patients with breast and lung cancer as well as renal carcinoma and squamous cell carcinoma in any organ and blood neoplasias, although it can be present in any cancer type. The humoral hypercalcemia of malignancy is the first physiopathology mechanism of hypercalcemia of malignancy; however, it can also be associated with osteolytic metastasis calcitriol and parathyroid hormone ectopic production. The malignant hypercalcemia is classified in mild with serum calcium rates among 10.5 mg/dl and 11.9, moderate rates among 10.5 mg/dl and 11.9 mg/dl and severe with rates higher than 14 mg/dl. The mild hypercalcemia generally does not have symptoms. The moderate and severe hypercalcemia are associated to a varied clinic presentation from gastrointestinal and neurologic symptoms to those related to hypovolemia deplecion. Treatment should focus on the physiology of the disorder. It is recommended to provide aggressive hydration and the use of medicines such as bisphosphonates, calcitonin or denosumab and in the cases that require it glucocorticoids and dialysis. The prognosis of patients with malignant hypercalcemia is poor and it is related to high rates of mortality.
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