{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T22:54:54Z","timestamp":1774479294880,"version":"3.50.1"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,3,9]]},"abstract":"<jats:p>A 54-year-old woman presented to our centre with acute abdominal pain and vomiting. Routine blood tests showed severe hypercalcaemia (&gt;4\u2005mmol\/L). Serum parathyroid hormone (PTH) was suppressed. CT scan detected a pancreatic mass and some liver lesions, initially suspicious for metastatic pancreatic adenocarcinoma. Liver biopsy however revealed the presence of a well-differentiated, grade 1, metastatic neuroendocrine tumour (NET) where prognosis is considerably better. Serum PTHrP was raised, indicating paraneoplastic hypercalcaemia, most likely secondary to the pancreatic NET. Following injection of a short-acting somatostatin analogue octreotide, serum PTHrP levels normalised within 24\u2005hours, causing a rapid drop of serum calcium below the lower limit of normal and an immediate compensatory rise of serum PTH. Ongoing treatment with long-acting somatostatin analogues together with replacement with calcium carbonate, vitamin D3 and once weekly alendronic acid resulted in stable normal adjusted calcium levels over a 3-month follow-up period.<\/jats:p>","DOI":"10.1136\/bcr-2017-219692","type":"journal-article","created":{"date-parts":[[2017,3,22]],"date-time":"2017-03-22T16:12:45Z","timestamp":1490199165000},"page":"bcr2017219692","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Malignant hypercalcaemia related to parathyroid hormone-related peptide (PTHrP) secretion from a metastatic pancreatic neuroendocrine tumour (NET)"],"prefix":"10.1136","volume":"2017","author":[{"given":"Megan","family":"Symington","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Louise","family":"Davies","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Kaltsas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin O","family":"Weickert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,3,22]]},"reference":[{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.1","doi-asserted-by":"publisher","DOI":"10.1385\/EP:14:4:303"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.2","doi-asserted-by":"publisher","DOI":"10.1677\/erc.1.00543"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.3","doi-asserted-by":"crossref","first-page":"3060","DOI":"10.1210\/jc.2014-1315","article-title":"Parathyroid hormone-related peptide (PTHrP) secretion by gastroenteropancreatic neuroendocrine tumors (GEP-NETs): clinical features, diagnosis, management, and follow-up","volume":"99","author":"Kamp","year":"2014","journal-title":"J Clin Endocrinol Metab"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.4","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198012113032401"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.5","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-2592"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.6","doi-asserted-by":"publisher","DOI":"10.1126\/science.3616618"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(05)70154-7"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.8","doi-asserted-by":"publisher","DOI":"10.1677\/joe.0.154S023"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.9","doi-asserted-by":"publisher","DOI":"10.1210\/er.2003-0014"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.10","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6600232"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.11","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.12968\/bjon.2016.25.4.S12","article-title":"Gastroenteropancreatic neuroendocrine tumours: an overview","volume":"25","author":"Davies","year":"2016","journal-title":"Br J Nurs"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.12","doi-asserted-by":"publisher","DOI":"10.1016\/S0039-6060(05)80227-2"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.13","doi-asserted-by":"publisher","DOI":"10.1007\/s00595-009-4190-7"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.14","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.2910460311"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.15","doi-asserted-by":"publisher","DOI":"10.1159\/000179899"},{"key":"2025042705430749000_2017.mar22_1.bcr2017219692.16","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.78.926.752"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-219692","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,27]],"date-time":"2025-04-27T12:43:12Z","timestamp":1745757792000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-219692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,22]]},"references-count":16,"alternative-id":["10.1136\/bcr-2017-219692"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-219692","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,22]]}}}