[Clinical thinking and decision making in practice. A patient with anal cancer and hypercalcemia]

Ned Tijdschr Geneeskd. 2000 Nov 18;144(47):2251-6.
[Article in Dutch]

Abstract

A 57-year-old male patient, recently known with an anal carcinoma with inguinal lymph node involvement, was admitted because of anorexia, nausea, vomiting and constipation. On physical examination the patient was dehydrated, and a systolic murmur, grade III/VI, punctum maximum apex cordis, was heard. Serum calcium was raised (4.50 mmol/l), as was the serum creatinine (328 mumol/l). Both values had been normal 14 days before admission. Serum parathormone was suppressed. A bone scan did not reveal evident lesions in the skeleton. FDG-PET scan showed uptake of the tracer into the bone marrow. A bone biopsy showed metastasis of a squamous cell carcinoma. Shortly after that the patient died. Hypercalcaemia is associated with cancer. Colorectal/anal carcinomas have a low incidence of hypercalcaemia. The prognosis of patients with cancer associated with hypercalcaemia is poor.

Publication types

  • Case Reports

MeSH terms

  • Anus Neoplasms / diagnosis*
  • Anus Neoplasms / pathology
  • Biopsy
  • Bone Marrow / diagnostic imaging
  • Bone Marrow / pathology
  • Bone Marrow Neoplasms / complications
  • Bone Marrow Neoplasms / diagnosis*
  • Bone Marrow Neoplasms / diagnostic imaging
  • Bone Marrow Neoplasms / secondary*
  • Carcinoma, Squamous Cell / complications
  • Carcinoma, Squamous Cell / diagnosis*
  • Carcinoma, Squamous Cell / diagnostic imaging
  • Carcinoma, Squamous Cell / secondary*
  • Diagnosis, Differential
  • Fatal Outcome
  • Groin
  • Humans
  • Hypercalcemia / etiology*
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Renal Insufficiency / etiology
  • Tomography, Emission-Computed