Table 1.
Cases of PTHrP-mediated hypercalcemia in adult patients with sarcoma
| # | References | Primary tumor | Age/gender | Mechanism | Treatment/outcome |
|---|---|---|---|---|---|
| 1 | Nagata et al. [11] | Leiomyosarcoma | 62 yo F |
PTHrP (radioimmunoassay on wet tissue) |
Oral fluids, calcitonin, chemotherapy. Developed pancreatitis and hypocalcemia, then died |
| 2* | Cross and Enoch [9] | Myxoid liposarcoma | 72 yo F | Likely PTHrP (suppressed PTH, bone scan without metastatic bone disease) | IV fluids, hydrocortisone, furosemide, calcitonin. Died 21 days after admission |
| 3 | Oleffe et al. [12] | Synoviosarcoma | 23 yo F | PTHrP (serum) | IV fluids, IV Ibandronate, radical surgery |
| 4 | Tang et al. [13] | Leiomyosarcoma | 61 yo F | PTHrP (serum, however upper end of normal range), 1,25 OH D (serum, elevated) | 1st: IV fluids, diuretics, IV pamidronate, calcitonin. Hypercalcemia spontaneously resolved after 3 mo. 2nd (years later): hypercalcemia resolved 10 min after tumor resection (PTHrP became undetectable) |
| 5 | Florez et al. [14] | Rhabdomyosarcoma | 71 yo M | PTHrP (normal serum level, but PTHrP-positive staining of cells on periphery of tumor) |
1st: IV fluids, pamidronate 2nd: IV zoledronic acid. Patient died from disease 6 months after diagnosis |
| 6* | Takamatsu et al. [7] | Uterine carcinosarcoma (with SCC in epithelial component) | 70 yo F | PTHrP (serum) | IV fluids, diuresis, bisphosphonate, surgery. Received prednisone for rheumatoid arthritis symptoms |
| 7 | Donovan et al. [1] | Myxoid liposarcoma | Did not report | PTHrP (serum) | No details provided regarding clinical course and treatment (paper is retrospective case series) |
| 8 | Motilal Nehru et al. [15] | Endometrial stromal sarcoma | 53 yo F | PTHrP (serum) | IV fluids, pamidronate, calcitonin, hemodialysis, and denosumab. Surgery, chemotherapy, and palliative radiation. Patient died from complications of malignancy |
| 9 | Jensen and Wang [16] | Angiosarcoma | 72 yo M | Primary hyperparathyroidism, and PTHrP (serum) |
1st: IV fluids, cinacalcet, calcitonin, parathyroidectomy 2nd: IV fluids, IV pamidronate, calcitonin. Patient transitioned to hospice |
| 10* | Kim et al. [8] | Liposarcoma | 89 yo F | 1,25 OH D and PTHrP (serum) |
1st: IV fluids, IV pamidronate 2nd: IV fluids, calcitonin, IV pamidronate, prednisone. Patient transitioned to hospice |
Note: "1st" indicates first admission, "2nd" indicates second admission
*Indicates a case in which glucocorticoids were part of the patient’s treatment