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Hypercalcaemia of malignancy — SCE Endocrinology MCQ

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HardCalcium/BoneHypercalcaemia of malignancySCE Endocrinology

A 40-year-old woman has thirst, nocturia and fatigue. Serum calcium is 2.98 mmol/L, PTH is suppressed, phosphate is normal and PTH-related peptide is raised. Chest CT shows a hilar lung mass. What is the most likely diagnosis?

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Correct answer: E — Humoral hypercalcaemia of malignancy

Humoral hypercalcaemia of malignancy is best because suppressed PTH with raised PTH-related peptide and lung mass indicates humoral hypercalcaemia of malignancy. The alternatives are less appropriate because primary, familial hypocalciuric and tertiary hyperparathyroidism have non-suppressed PTH; vitamin D deficiency usually causes low or normal calcium. The SCE teaching point is to integrate the clinical pattern, biochemistry and context rather than treating an isolated result.

Reference: Society for Endocrinology hypercalcaemia emergency guidance