Defined as having a corrected calcium level greater than 2.65mmol/L

Aetiology

• Hypercalcemia of malignancy occurs in approximately 20% of all cancer patients during their clinical course
• The most common cancer associated with hypercalcemia is multiple myeloma

Pathophysiology

• The pathophysiology of hypercalcemia of malignancy is explained mainly through three mechanisms: excessive secretion of parathyroid hormone-related protein (PTHrP), bony metastases with the release of osteoclast activating factors, or the production of 1,25-dihydroxy vitamin D (calcitriol)

Clinical features

General

• Gallstones (STONES)
• Bone pain (BONES)
• Abdominal pain (GROANS)
• Psychiatric disturbances (PSYCHIC MOANS)

Acute

• Thirst
• Dehydration
• Confusion
• Polyuria

Chronic

• Myopathy
• Fractures