{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T22:57:06Z","timestamp":1790117826520,"version":"4.0.1"},"reference-count":10,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Hypercalcemia of malignancy is relatively common in several cancers. However, in colorectal cancer, paraneoplastic phenomena that cause hypercalcemia is uncommon. In the few cases that are reported, secretion of parathyroid hormone-related peptide mediates the effect. We describe the first case of severe hypercalcemia mediated by intact parathyroid hormone secretion from a bone metastasis of colorectal origin. This was a diagnostic and therapeutic challenge.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 68-year-old male treated for rectal adenocarcinoma 10\u2009years earlier developed a bone metastasis. After initial treatment of the metastasis with surgery and irradiation, he developed a relapse with severe hypercalcemia and corresponding elevated parathyroid hormone levels. The workup showed no signs of parathyroid adenomas, but the metastasis produced intact parathyroid hormone. The hypercalcemia was successfully treated by irradiation and osteoclast inhibitor, and the patient received chemotherapy. Survival was 24\u2009months from the onset of hypercalcemia.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Proper diagnosis of the uncommon endocrine disturbance allowed targeted therapy and avoidance of neck exploration for wrongly suspecting primary hyperparathyroidism. Intact parathyroid hormone should be measured in cases of malignant hypercalcemia.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12902-020-00664-8","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T14:03:57Z","timestamp":1610028237000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Severe hypercalcemia caused by parathyroid hormone in a rectal cancer metastasis: a case report"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4136-3073","authenticated-orcid":false,"given":"Vegard Heimly","family":"Brun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik","family":"Knutsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helge","family":"Stenvold","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanne","family":"Halvorsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"issue":"4","key":"664_CR1","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1056\/NEJMcp042806","volume":"352","author":"AF Stewart","year":"2005","unstructured":"Stewart AF. Clinical practice. Hypercalcemia associated with cancer. N Engl J Med. 2005;352(4):373\u20139.","journal-title":"N Engl J Med"},{"issue":"7","key":"664_CR2","doi-asserted-by":"publisher","first-page":"499","DOI":"10.7326\/0003-4819-112-7-499","volume":"112","author":"SH Ralston","year":"1990","unstructured":"Ralston SH, Gallacher SJ, Patel U, Campbell J, Boyle IT. Cancer-associated hypercalcemia: morbidity and mortality. Clinical experience in 126 treated patients. Ann Intern Med. 1990;112(7):499\u2013504.","journal-title":"Ann Intern Med"},{"issue":"1","key":"664_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00223-001-1135-6","volume":"74","author":"SH Ralston","year":"2004","unstructured":"Ralston SH, Coleman R, Fraser WD, Gallagher SJ, Hosking DJ, Iqbal JS, et al. Medical management of hypercalcemia. Calcif Tissue Int. 2004;74(1):1\u201311.","journal-title":"Calcif Tissue Int"},{"issue":"3","key":"664_CR4","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1677\/erc.1.00543","volume":"12","author":"GA Clines","year":"2005","unstructured":"Clines GA, Guise TA. Hypercalcaemia of malignancy and basic research on mechanisms responsible for osteolytic and osteoblastic metastasis to bone. Endocr Relat Cancer. 2005;12(3):549\u201383.","journal-title":"Endocr Relat Cancer"},{"issue":"10","key":"664_CR5","doi-asserted-by":"publisher","first-page":"4023","DOI":"10.1210\/jc.2013-2016","volume":"98","author":"PJ Donovan","year":"2013","unstructured":"Donovan PJ, Sundac L, Pretorius CJ, d'Emden MC, McLeod DS. Calcitriol-mediated hypercalcemia: causes and course in 101 patients. J Clin Endocrinol Metab. 2013;98(10):4023\u20139.","journal-title":"J Clin Endocrinol Metab"},{"issue":"4","key":"664_CR6","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1007\/BF01675660","volume":"15","author":"D Casanova","year":"1991","unstructured":"Casanova D, Sarfati E, De Francisco A, Amado JA, Arias M, Dubost C. Secondary hyperparathyroidism: diagnosis of site of recurrence. World J Surg. 1991;15(4):546\u20139 discussion 9-50.","journal-title":"World J Surg"},{"issue":"1","key":"664_CR7","doi-asserted-by":"publisher","first-page":"5","DOI":"10.14740\/wjon953w","volume":"7","author":"RJ Galindo","year":"2016","unstructured":"Galindo RJ, Romao I, Valsamis A, Weinerman S, Harris YT. Hypercalcemia of malignancy and colorectal cancer. World J Oncol. 2016;7(1):5\u201312.","journal-title":"World J Oncol"},{"issue":"2","key":"664_CR8","doi-asserted-by":"publisher","first-page":"160","DOI":"10.1097\/00000421-200204000-00011","volume":"25","author":"JY Luh","year":"2002","unstructured":"Luh JY, Han ES, Simmons JR, Whitehead RP. Poorly differentiated colon carcinoma with neuroendocrine features presenting with hypercalcemia and cutaneous metastases: case report and review of the literature. Am J Clin Oncol. 2002;25(2):160\u20133.","journal-title":"Am J Clin Oncol"},{"issue":"3","key":"664_CR9","doi-asserted-by":"publisher","first-page":"397","DOI":"10.1093\/carcin\/21.3.397","volume":"21","author":"JB Little","year":"2000","unstructured":"Little JB. Radiation carcinogenesis. Carcinogenesis. 2000;21(3):397\u2013404.","journal-title":"Carcinogenesis."},{"issue":"1\u20132","key":"664_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1615\/CritRevOncog.2018025687","volume":"23","author":"IR Miousse","year":"2018","unstructured":"Miousse IR, Ewing LE, Kutanzi KR, Griffin RJ, Koturbash I. DNA methylation in radiation-induced carcinogenesis: experimental evidence and clinical perspectives. Crit Rev Oncog. 2018;23(1\u20132):1\u201311.","journal-title":"Crit Rev Oncog"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-020-00664-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/s12902-020-00664-8\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-020-00664-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,1,8]],"date-time":"2021-01-08T00:28:12Z","timestamp":1610065692000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-020-00664-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,1,7]]},"references-count":10,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2021,12]]}},"alternative-id":["664"],"URL":"https:\/\/doi.org\/10.1186\/s12902-020-00664-8","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,1,7]]},"assertion":[{"value":"21 April 2020","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 December 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient\u2019s next of kin for publication of this Case Report and accompanying figures. A copy of the written consent is available for review by the Editor of this journal.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"4"}}