Treatment of malignancy associated hypercalcemia

Abstract

Malignancy associated hypercalcemia (MAH) is a paraneoplastic syndrome that impairs the quality of life and that can be a direct cause of death. MAH is classified into two major categories : humoral hypercalcemia of malignancy (HHM) and local osteolytic hypercalcemia (LOH) . Bisphosphonates are the gold standard of treatment for MAH, because enhanced resorption causing a massive calcium mobilization from bone plays a central role in the pathogenesis of MAH. Calcitonin can be used initially as an adjunctive therapy, because it takes a few days for bisphosphonates to be effective. Saline infusion is also necessary to improve dehydration and renal insufficiency inevitably accompanying MAH.