World J Oncol

World Journal of Oncology, ISSN 1920-4531 print, 1920-454X online, Open Access

Article copyright, the authors; Journal compilation copyright, World J Oncol and Elmer Press Inc

Journal website http://www.wjon.org

Case Report

Volume 7, Number 1, February 2016, pages 5-12

Hypercalcemia of Malignancy and Colorectal Cancer

Figure 1. Corrected calcium and response to therapy. Black arrows represent treatment with zoledronic acid; green dashed-arrows represent chemotherapy and dexamethasone; red horizontal lines represent prednisone treatment (40 mg daily).

Figure 2. Calcitriol levels and response to steroids and chemotherapy. Green arrows represent chemotherapy and dexamethasone; red horizontal lines represent prednisone treatment (40 mg daily).

**Table 1.** Cases of Colorectal Cancer and Humoral Hypercalcemia of Malignancy
Case number	Year (reference)	Age	Sex	Histological diagnosis	Metastasis	Calcium (mg/dL)	PTHrP (pmol/L)
Ca: highest calcium (mg/dL); PTHrP: highest parathyroid hormone-related peptide (pmol/L). Histology: Cac: colon adenocarcinoma; Cas: colon adenosquamous carcinoma; Rc: rectal carcinoma; Rac: rectal adenocarcinoma; Ras: rectal adenosquamous; Cc: colon cancer unspecified; Ac: anal carcinoma; Ascc: anal squamous cell carcinoma. *Neuroendocrine features. Metastasis: Li: liver; LN: lymph node; P: pulmonary; Per: peritoneum; Ad: adrenal; B: bone; T: thyroid; NR: no reported; No: no metastasis; S: skin; Pr: prostate.
1	1963 [35]	77	M	Cac	Li, LN	14	NR
2	1969 [36]	46	M	Cac	Li	15	NR
3	1969 [25]	79	M	Cc	NR	17.8	NR
4	1980 [18]	43	M	Cas	Li, P, K	18.4	NR
5	1980 [18]	39	M	Ras	Li, A	15.8	NR
6	1985 [26]	67	F	Ras*	Li, P, T, B, Per, Ad	16	NR
7	1987 [23]	41	F	Cas	Li	NR	NR
8	1987 [12]	41	F	Cas	Li, LN	18.4	NR
9	1989 [11]	74	M	Cas	Li, P	14.5	NR
10	1991 [22]	58	M	Rac	Li	17.6	NR
Cases reported after commercial assays became available
11	1993 [16]	NR	NR	Cc	NR	NR	10
12	1993 [16]	NR	NR	Cc	NR	NR	20
13	1994 [19]	58	M	Cas	Li	11.9	25
14	1995 [14]	52	F	Rac	Li	18	162
15	1995 [24]	60	M	Ac	Pr, LN	17.3	33.2
16	1996 [31]	75	M	Cac*	Li, LN	13.2	36.7
17	1996 [27]	37	F	Cas	Li, LN	NR	NR
18	1998 [29]	47	M	Cc	NR	16	NR
19	1999 [20]	54	F	Cac*	Li, LN	15.2	18
20	1999 [20]	63	M	Rac	Li, P, LN, S	17	9.3
21	2001 [33]	76	F	Cas	Li, LN, S	13.6	25.7
22	2002 [21]	42	M	Cac*	Li, LN, B, S	16.2	12.1
23	2005 [15]	78	F	Cas	No	13.2	3.7
24	2005 [28]	54	F	Cac	Li, LN, P	14.2	13.5
25	2006 [13]	59	F	Rc*	LN	12.7	6.4
26	2008 [32]	57	M	Ascc	No	14	NR
27	2009 [17]	40	F	Ascc	No	15.8	HIGH
28	2010 [30]	52	F	Ascc	No	17.2	NR
29	2011 [34]	64	M	Ascc	LN	17.6	3.4

Table 1. Cases of Colorectal Cancer and Humoral Hypercalcemia of Malignancy

Case number

Year (reference)

Age

Sex

Histological diagnosis

Metastasis

Calcium (mg/dL)

PTHrP (pmol/L)

Ca: highest calcium (mg/dL); PTHrP: highest parathyroid hormone-related peptide (pmol/L). Histology: Cac: colon adenocarcinoma; Cas: colon adenosquamous carcinoma; Rc: rectal carcinoma; Rac: rectal adenocarcinoma; Ras: rectal adenosquamous; Cc: colon cancer unspecified; Ac: anal carcinoma; Ascc: anal squamous cell carcinoma. *Neuroendocrine features. Metastasis: Li: liver; LN: lymph node; P: pulmonary; Per: peritoneum; Ad: adrenal; B: bone; T: thyroid; NR: no reported; No: no metastasis; S: skin; Pr: prostate.

1963 [35]

Cac

Li, LN

1969 [36]

Cac

1969 [25]

17.8

1980 [18]

Cas

Li, P, K

18.4

1980 [18]

Ras

Li, A

15.8

1985 [26]

Ras*

Li, P, T, B, Per, Ad

1987 [23]

Cas

1987 [12]

Cas

Li, LN

18.4

1989 [11]

Cas

Li, P

14.5

1991 [22]

Rac

17.6

Cases reported after commercial assays became available

1993 [16]

1994 [19]

Cas

11.9

1995 [14]

Rac

162

1995 [24]

Pr, LN

17.3

33.2

1996 [31]

Cac*

Li, LN

13.2

36.7

1996 [27]

Cas

Li, LN

1998 [29]

1999 [20]

Cac*

Li, LN

15.2

1999 [20]

Rac

Li, P, LN, S

9.3

2001 [33]

Cas

Li, LN, S

13.6

25.7

2002 [21]

Cac*

Li, LN, B, S

16.2

12.1

2005 [15]

Cas

13.2

3.7

2005 [28]

Cac

Li, LN, P

14.2

13.5

2006 [13]

Rc*

12.7

6.4

2008 [32]

Ascc

2009 [17]

Ascc

15.8

HIGH

2010 [30]

Ascc

17.2

2011 [34]

Ascc

17.6

3.4

**Table 2.** Cases of Combined Paraneoplastic Production of Parathyroid Hormone-Related Peptide (PTHrP) and Calcitriol
Case number	Year (reference)	Age	Sex	Histological diagnosis	Metastasis	Calcium (8.4 - 10.5 mg/dL)	PTHrP (< 2 pmol/L)	Calcitriol (18 - 64 pg/mL)
RCC: renal cell carcinoma; Oac: ovarian adenocarcinoma; PNE: pancreatic neuroendocrine tumor; Ascc: anal squamous cell carcinoma. Metastasis: Li: liver. Calcium, PTHrP and calcitriol: highest reported values.
1	1991 [39]	70	F	Oac	No	13.08	NR	285
2	2000 [38]	54	F	Oac	No	16.8	10	104
3	2006 [37]	74	F	Oac	No	12.8	60.4	116
4	2007 [41]	59	M	PNE	No	18.9	7.3	71.5
5	2009 [40]	57	M	RCC	Li	12.9	3.4	79

Table 2. Cases of Combined Paraneoplastic Production of Parathyroid Hormone-Related Peptide (PTHrP) and Calcitriol

Case number

Year (reference)

Age

Sex

Histological diagnosis

Metastasis

Calcium (8.4 - 10.5 mg/dL)

PTHrP (< 2 pmol/L)

Calcitriol (18 - 64 pg/mL)

RCC: renal cell carcinoma; Oac: ovarian adenocarcinoma; PNE: pancreatic neuroendocrine tumor; Ascc: anal squamous cell carcinoma. Metastasis: Li: liver. Calcium, PTHrP and calcitriol: highest reported values.

1991 [39]

Oac

13.08

285

2000 [38]

Oac

16.8

104

2006 [37]

Oac

12.8

60.4

116

2007 [41]

PNE

18.9

7.3

71.5

2009 [40]

RCC

12.9

3.4