Abstract
Background. Hypercalcemia is a rare but potentially dangerous complication of pediatric cancer. Of the dysgerminoma cases reported to date, associated hypercalcemia is corrected within 2–7 days of tumor resection. Case. A 13-year-old female with an ovarian dysgerminoma was found to be hypercalcemic on presentation. Following dysgerminoma resection, moderate hypercaclemia persisted for 7 days and calcium remained mildly elevated for an additional 7 days. PTHrP was undetectable. Immunolocalization studies indicated that 1α-hydroxylase was expressed in dysgerminoma tissue but 1,25(OH)2D3 was not elevated. Conclusion. Persistently elevated calcium levels following tumor resection suggests that this case involves a previously undescribed mechanism. Elucidation of this mechanism may offer new insights into tumor biology and opportunities for therapeutic correction of hypercalcemia in this patient population.
Highlights
Humoral hypercalcemia of malignancy (HHM) is a rare but potentially dangerous complication of pediatric cancer
We report a case of hypercalcemia associated with a dysgerminoma in which the etiology of hypercalcemia was not determined, in spite of extensive evaluation
Not resulting from bone marrow invasion, is termed HHM, and is caused by factors secreted by tumors into the circulation
Summary
Hypercalcemia is a rare but potentially dangerous complication of pediatric cancer. Of the dysgerminoma cases reported to date, associated hypercalcemia is corrected within 2–7 days of tumor resection. A 13-year-old female with an ovarian dysgerminoma was found to be hypercalcemic on presentation. Moderate hypercaclemia persisted for 7 days and calcium remained mildly elevated for an additional 7 days. Immunolocalization studies indicated that 1α-hydroxylase was expressed in dysgerminoma tissue but 1,25(OH)2D3 was not elevated. Elevated calcium levels following tumor resection suggests that this case involves a previously undescribed mechanism. Elucidation of this mechanism may offer new insights into tumor biology and opportunities for therapeutic correction of hypercalcemia in this patient population
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