Abstract
Background A 70-year-old man presented with a smooth lump on his buccal mucosa and right-sided cervical lymphadenopathy. Staging investigations revealed extensive sclerotic bone metastases and the patient subsequently underwent palliative radiotherapy to the right face and cervical region. Seven months later he presented with a 4-day history of fatigue, muscle cramps, ataxia, paraesthesia, and blurred vision.
Investigations Physical examination, biopsy of abnormal buccal mucosa, routine biochemistry, electrocardiogram, bone scan, CT scans of the chest, abdomen and pelvis, and MRI of the brain.
Diagnosis Undifferentiated carcinoma of the salivary gland with sclerotic bone metastases and hypocalcemia.
Management Palliative radiotherapy to the right face and cervical region, infusions of calcium gluconate and calcium chloride, oral calcium carbonate, vitamin D and magnesium, palliative chemotherapy (carboplatin and 5-fluorouracil), and whole brain radiotherapy.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$209.00 per year
only $17.42 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
Bergkamp FJ et al. (2003) Unexpected prolonged extreme hypocalcaemia and an inadequate PTH response in a patient with metastatic breast carcinoma. Neth J Med 61: 371–375
Lim SC et al. (2000) A man with osteoblastic metastasis and hypocalcaemia. Singapore Med J 41: 74–76
Riancho JA et al. (1989) The clinical spectrum of hypocalcaemia associated with bone metastases. J Intern Med 226: 449–452
Smallridge RC et al. (1981) Hypocalcemia with osteoblastic metastases in patient with prostate carcinoma. A cause of secondary hyperparathyroidism. Am J Med 71: 184–188
Raskin P et al. (1973) Hypocalcemia associated with metastatic bone disease. A retrospective study. Arch Intern Med 132: 539–543
Tommaso CL and Tucci JR (1979) Metabolic studies in a case of hypocalcemia and osteoblastic metastases. Arch Intern Med 139: 238–241
Randall RE Jr and Lirenman DS (1964) Hypocalcemia and hypophosphate accompanying osteoblastic metastases. J Clin Endocrinol Metab 24: 1331–1333
Kukreja SC et al. (1988) Hypocalcemia in patients with prostate cancer. Calcif Tissue Int 43: 340–345
Abramson EC et al. (1990) Hypocalcemia in cancer. Bone Miner 10: 161–169
Simpson E et al. (1985) Identification of a messenger ribonucleic acid fraction in human prostatic cancer cells coding for a novel osteoblast-stimulating factor. Endocrinology 117: 1615–1620
Wiegmann T and Kaye M (1977) Hypomagnesemic hypocalcemia. Early serum calcium and late parathyroid hormone increase with magnesium therapy. Arch Intern Med 137: 953–955
Acknowledgements
The authors thank CS Lavery for his support of this project. Written consent for publication was obtained from the patient.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing financial interests.
Rights and permissions
About this article
Cite this article
Dawson, SJ., Murray, R. & Rischin, D. Hypocalcemia associated with bone metastases in a patient with salivary-gland carcinoma. Nat Rev Clin Oncol 3, 104–107 (2006). https://doi.org/10.1038/ncponc0405
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1038/ncponc0405
