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While malignancy associated hypercalcemia is a common finding among 20% to 30% of adult patients with breast cancer, lung cancer and multiple myeloma, it happens in less than 5% of female genital tract malignancies.  The three most common mechanisms associated with hypercalcemia are: local osteolytic hypercalcemia, humoral hypercalcemia of malignancy (HHM) caused by the parathyroid hormone-related peptide (PTHrP), and other humoral factors including prostaglandin, tumor necrosis factor (TNF), osteoclast activating factor and transforming growth factor (TGF). PTHrP and 1, 25 dihydroxy vitamin D (1, 25 Vit D) have been reported as humoral factors for dysgermininoma.  Humoral hypercalcemia of malignancy (HHM) can be caused by ectopic paraneoplastic production of 1, 25 dihydroxy vitamin D due to hyperactivity of 1 alpha-hydroxylase enzyme.
Medicine and Health Sciences
Iqbal, Iqra; Khan, Muhammad Atique Alam; Dhillon, Puneet; Munir, Samavia; and Nabwani, Dina, "Hypercalcemia related to ectopic vitamin D production from a dysgerminoma" (2019). Abington Jefferson Health Posters. 3.