{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:30:58Z","timestamp":1772580658108,"version":"3.50.1"},"reference-count":13,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T00:00:00Z","timestamp":1731542400000},"content-version":"vor","delay-in-days":7,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["T32DK007245"],"award-info":[{"award-number":["T32DK007245"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Hypercalcemia is most commonly associated with primary hyperparathyroidism or malignancy in the setting of elevated parathyroid hormone-related protein or bone metastases. Calcitriol (1,25-dihydroxyvitamin D)-mediated hypercalcemia is rare and typically associated with granulomatous conditions; however, other solid-organ etiologies have been reported. Here, we detail the case of a 62-year-old man with metastatic pancreatic neuroendocrine tumor (pNET) with hypercalcemia refractory to traditional bisphosphonate therapy in the setting of vastly elevated 1,25-dihydroxyvitamin D. Only after initiation of chemotherapy with capecitabine and temozolomide did his serum calcium consistently improve and 1,25-dihydroxyvitamin D begin to decrease. There are fewer than 5 reported cases of a pNET resulting in calcitriol-mediated hypercalcemia. Prompt initiation of treatment for the underlying condition can result in a significant improvement in serum calcium or 1,25-dihydroxyvitamin D. Multiple reports have also demonstrated success with high-dose steroid administration in patients with other solid-organ etiologies of calcitriol-mediated hypercalcemia, but this has not yet been reviewed in the pNET population.<\/jats:p>","DOI":"10.1210\/jcemcr\/luae209","type":"journal-article","created":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T13:45:25Z","timestamp":1731591925000},"source":"Crossref","is-referenced-by-count":1,"title":["Calcitriol-Mediated Hypercalcemia Due to Liver Metastases in a Patient With Primary Pancreatic Neuroendocrine Tumor"],"prefix":"10.1210","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8540-8248","authenticated-orcid":false,"given":"Katherine I","family":"Wolf","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, Michigan Medicine , Ann Arbor, MI 48109 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oxana V","family":"Crysler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Hematology and Oncology, Michigan Medicine , Ann Arbor, MI 48109 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Fontana","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Gastroenterology and Hepatology, Michigan Medicine , Ann Arbor, MI 48109 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4234-9473","authenticated-orcid":false,"given":"Sima","family":"Saberi","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism, Endocrinology & Diabetes, Michigan Medicine , Ann Arbor, MI 48109 ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2024,11,14]]},"reference":[{"issue":"16","key":"2024121021104535100_luae209-B1","doi-asserted-by":"crossref","first-page":"1624","DOI":"10.1001\/jama.2022.18331","article-title":"Hypercalcemia: a review","volume":"328","author":"Walker","year":"2022","journal-title":"JAMA"},{"key":"2024121021104535100_luae209-B2","doi-asserted-by":"crossref","first-page":"812385","DOI":"10.3389\/fendo.2021.812385","article-title":"Calcitriol-Mediated hypercalcemia, somatostatin receptors expression, and 25-hydroxyvitamin D3-1a hydroxylase in GIST tumors","volume":"12","author":"Herrera-Martinez","year":"2022","journal-title":"Front Endocrinol"},{"issue":"10","key":"2024121021104535100_luae209-B3","doi-asserted-by":"crossref","first-page":"4023","DOI":"10.1210\/jc.2013-2016","article-title":"Calcitriol-Mediated hypercalcemia: causes and course in 101 patients","volume":"98","author":"Donovan","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"key":"2024121021104535100_luae209-B4","first-page":"9160326","article-title":"Pembrolizumab induced calcitriol-mediated hypercalcemia","volume":"2023","author":"Oomen","year":"2023","journal-title":"Case Rep Neprhol"},{"issue":"4","key":"2024121021104535100_luae209-B5","first-page":"E84","article-title":"Hypercalcemia from metastatic pancreatic neuroendocrine tumor secreting 1,25-dihydroxyvitamin D","volume":"5","author":"Zhu","year":"2014","journal-title":"J Gastrointest Oncol"},{"issue":"12","key":"2024121021104535100_luae209-B6","doi-asserted-by":"crossref","first-page":"rjz346","DOI":"10.1093\/jscr\/rjz346","article-title":"Hypercalcemia due to a calcitriol-producing neuroendocrine tumor","volume":"12","author":"Van Lierop","year":"2019","journal-title":"J Surg Case Rep"},{"issue":"5","key":"2024121021104535100_luae209-B7","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1590\/2359-3997000000291","article-title":"Use of cinacalcet and sunitinib to treat hypercalcemia due to a pancreatic neuroendocrine tumor","volume":"61","author":"Valdes-Socin","year":"2017","journal-title":"Arch Endocrinol Metab"},{"issue":"5","key":"2024121021104535100_luae209-B8","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1007\/s10620-012-2493-9","article-title":"Clinical and histological features of idiosyncratic acute liver injury caused by temozolomide","volume":"58","author":"Grant","year":"2013","journal-title":"Dig Dis Sci"},{"issue":"3","key":"2024121021104535100_luae209-B9","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.aace.2020.11.037","article-title":"Hypercalcemia of malignancy: simultaneous elevation in parathyroid hormone-related peptide and 1,25 dihydroxyvitamin D in sarcoma","volume":"7","author":"Kim","year":"2021","journal-title":"AACE Clin Case Rep"},{"issue":"2","key":"2024121021104535100_luae209-B10","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1002\/cncr.25425","article-title":"First-Line chemotherapy with capecitabine and temozolomide in patients with metastatic pancreatic endocrine carcinomas","volume":"117","author":"Strosberg","year":"2011","journal-title":"Cancer"},{"issue":"3","key":"2024121021104535100_luae209-B11","doi-asserted-by":"crossref","first-page":"663","DOI":"10.1007\/s00280-012-2055-z","article-title":"Capecitabine and temozolomide (CAPTEM) for metastatic, well-differentiated neuroendocrine cancers: the pancreas center at Columbia university experience","volume":"71","author":"Fine","year":"2013","journal-title":"Cancer Chemother Pharmacol"},{"issue":"6","key":"2024121021104535100_luae209-B12","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1634\/theoncologist.2015-0470","article-title":"The r\u00f4le of capecitabine\/temozolomide in metastatic neuroendocrine tumors","volume":"21","author":"Ramirez","year":"2016","journal-title":"Oncologist"},{"issue":"155","key":"2024121021104535100_luae209-B13","doi-asserted-by":"crossref","first-page":"190146","DOI":"10.1183\/16000617.0146-2019","article-title":"Delphi consensus recommendations for a treatment algorithm in pulmonary sarcoidosis","volume":"29","author":"Rahaghi","year":"2020","journal-title":"Eur Respir Rev"}],"container-title":["JCEM Case 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