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Case Report
 
1,25-Dihydroxyvitamin D-mediated hypercalcemia in a patient with malignancy without lymphoma
Katie Mastoris1, Sarah Park1, Vasudev Magaji2
1D.O, Department of Medicine, Lehigh Valley Health Network, Allentown PA.
2MD, Division of Endocrinology, Department of Medicine, Lehigh Valley Health Network, Allentown PA.

doi:10.5348/ijcri-201566-CR-10527

Address correspondence to:
Vasudev Magaji
MD, Division of Endocrinology, Department of Medicine
Lehigh Valley Health Network
Allentown PA 18103
Phone: 610-402-6790
Fax: 610-402-6979

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How to cite this article
Mastoris K, Park S, Magaji V. 1,25-Dihydroxyvitamin D-mediated hypercalcemia in a patient with malignancy without lymphoma. Int J Case Rep Images 2015;6(7):403–406.


Abstract
Introduction: Hypercalcemia resulting from calcium homeostasis imbalance is seen in one-third of malignancies. Solid malignancies cause hypercalcemia from high parathyroid hormone-related peptide (PTHrP) and, infrequently, from osteolytic cytokines. Excessive 1, 25-dihydroxyvitamin D, seen mostly in lymphoma, causes hypercalcemia by 1-alpha-hydroxylation of 25-hydroxyvitamin D. This mechanism has also been reported in a few cases of dysgerminoma, myofibroblastic tumors, and gastrointestinal stromal tumors.
Case Report: We present an unusual case of 1,25-dihydroxyvitamin D mediated hypercalcemia in a 62-year-old male with colonic adenocarcinoma and mesothelioma.
Conclusion: This case emphasizes that elevated 1,25-dihydroxyvitamin D may be a hypercalcemia etiology in non-lymphoma malignancies and should to be considered when workup for elevated PTHrP and osteolytic hypercalcemia is negative.

Keywords: Adenocarcinoma, 1-alpha-hydroxylase, 1,25-dihydroxyvitamin D, Hypercalcemia, Mesothelioma


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Author Contributions
Katie Mastoris – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Sarah Park – Substantial contribution to design, acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Vasudev Magaji – Substantial contribution to design, acquisition of data, Analysis and interpretation of data, Revising the article critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Katie Mastoris et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.