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. 1969 Nov;22(6):718–724. doi: 10.1136/jcp.22.6.718

Bronchial carcinoma and hypercalcaemia

J G Azzopardi 1, R S Whittaker 1
PMCID: PMC474367  PMID: 5365347

Abstract

Hypercalcaemia due to malignant disease, in the absence of bone metastases, is generally regarded as a rare event. It occurred in 16% of a series of cases of bronchial carcinoma coming to necropsy. Hypercalcaemia is a relatively common complication of bronchial carcinoma.

The hypercalcaemia is usually accompanied by hypophosphataemia and, in this respect, must be distinguished from the hypercalcaemia that may be found with breast carcinoma. It is frequently accompanied by hypokalaemic alkalosis; this must not be confused with the metabolic disorder that results from the production of ectopic `ACTH'.

The bones sometimes show changes of osteitis fibrosa akin to those seen in hyperparathyroidism. Cystic disease of bone recognizable radiologically is rare, probably because of the relatively short duration of the metabolic disturbance.

The parathyroids are usually mildly atrophic. There is no evidence that the main pathogenetic mechanism is stimulation of the parathyroids by the tumour. Acceptable instances of parathyroid hyperplasia are very rare: the significance of these exceptional cases awaits further study.

Squamous carcinoma of the bronchus is the type mainly incriminated. Oat-cell carcinoma and bronchial adenocarcinoma are involved less frequently than expected by chance. The significance of the tumour types implicated is discussed in relation to the possible pathogenesis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Azzopardi J. G., Williams E. D. Pathology of 'nonendocrine' tumors associated with Cushing's syndrome. Cancer. 1968 Aug;22(2):274–286. doi: 10.1002/1097-0142(196808)22:2<274::aid-cncr2820220204>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  2. Carey V. C. The incidence of hypercalcemia in association with bronchogenic carcinoma. Am Rev Respir Dis. 1966 Apr;93(4):584–586. doi: 10.1164/arrd.1966.93.4.584. [DOI] [PubMed] [Google Scholar]
  3. GAULT M. H., KINSELLA T. D. CARCINOMA OF LUNG WITH ADRENAL HYPERFUNCTION AND HYPERCALCEMIA TREATED BY PARATHYROIDECTOMY. Can Med Assoc J. 1965 Feb 13;92:317–324. [PMC free article] [PubMed] [Google Scholar]
  4. GELLHORN A., PLIMPTON C. H. Hypercalcemia in malignant disease without evidence of bone destruction. Am J Med. 1956 Nov;21(5):750–759. [PubMed] [Google Scholar]
  5. GOLDBERG M. F., TASHJIAN A. H., Jr, ORDER S. E., DAMMIN G. J. RENAL ADENOCARCINOMA CONTAINING A PARATHYROID HORMONE-LIKE SUBSTANCE AND ASSOCIATED WITH MARKED HYPERCALCEMIA. Am J Med. 1964 May;36:805–814. doi: 10.1016/0002-9343(64)90188-3. [DOI] [PubMed] [Google Scholar]
  6. Gordon G. S., Cantino R. J., Erhardt L., Hansen J., Lubich W. Osteolytic sterol in human breast cancer. Science. 1966 Mar 11;151(3715):1226–1228. doi: 10.1126/science.151.3715.1226. [DOI] [PubMed] [Google Scholar]
  7. Grimes B. J., Fisher B., Finn F., Danowski T. S. Steroid-resistent hypercalcaemia and parathyroid hyperplasia in non-osseous cancer. Acta Endocrinol (Copenh) 1967 Nov;56(3):510–520. doi: 10.1530/acta.0.0560510. [DOI] [PubMed] [Google Scholar]
  8. KELLER R. T., GOLDSCHNEIDER I., LAFFERTY F. W. HYPERCALCEMIA SECONDARY TO A PRIMARY HEPATOMA. JAMA. 1965 May 31;192:782–784. doi: 10.1001/jama.1965.03080220046020. [DOI] [PubMed] [Google Scholar]
  9. LAMBERG B. A., PELKONEN R., FRICK M. H. HYPERCALCAEMIA IN RENAL CARCINOMA. REPORT OF A CASE. Acta Med Scand. 1964 Aug;176:187–194. doi: 10.1111/j.0954-6820.1964.tb00925.x. [DOI] [PubMed] [Google Scholar]
  10. LIPSETT M. B., ODELL W. D., ROSENBERG L. E., WALDMANN T. A. HUMORAL SYNDROMES ASSOCIATED WITH NONENDOCRINE TUMORS. Ann Intern Med. 1964 Oct;61:733–756. doi: 10.7326/0003-4819-61-4-733. [DOI] [PubMed] [Google Scholar]
  11. LOCKS M. O. Incidence of hypercalcemia in patients with proved carcinoma of the lung. J Lancet. 1962 Apr;82:165–167. [PubMed] [Google Scholar]
  12. MASSARO D. J., OWEN J. A., Jr Persistent hypercalcemia associated with bronchogenic carcinoma and primary chiefcell hyperplasia of the parathyroids. Am Rev Respir Dis. 1962 May;85:727–734. doi: 10.1164/arrd.1962.85.5.727. [DOI] [PubMed] [Google Scholar]
  13. SNEDECOR P. A., BAKER H. W. PSEUDOHYPERPARATHYROIDISM DUE TO MALIGNANT TUMORS. Cancer. 1964 Nov;17:1492–1496. doi: 10.1002/1097-0142(196411)17:11<1492::aid-cncr2820171119>3.0.co;2-#. [DOI] [PubMed] [Google Scholar]
  14. Sherwood L. M., O'Riordan J. L., Aurbach G. D., Potts J. T., Jr Production of parathyroid hormone by nonparthyroid tumors. J Clin Endocrinol Metab. 1967 Jan;27(1):140–146. doi: 10.1210/jcem-27-1-140. [DOI] [PubMed] [Google Scholar]
  15. Strickland N. J., Bold A. M., Medd W. E. Bronchial carcinoma with hypercalcaemia simulating cerebral metastases. Br Med J. 1967 Sep 2;3(5565):590–592. doi: 10.1136/bmj.3.5565.590. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. TASHJIAN A. H., Jr, LEVINE L., MUNSON P. L. IMMUNOCHEMICAL IDENTIFICATION OF PARATHYROID HORMONE IN NON-PARATHYROID NEOPLASMS ASSOCIATED WITH HYPERCALCEMIA. J Exp Med. 1964 Mar 1;119:467–484. doi: 10.1084/jem.119.3.467. [DOI] [PMC free article] [PubMed] [Google Scholar]

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