{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:14:05Z","timestamp":1788275645834,"version":"build-2803163510"},"reference-count":13,"publisher":"Scientific Scholar","content-domain":{"domain":["jpalliativecare.com"],"crossmark-restriction":true},"short-container-title":["IJPC"],"abstract":"<jats:p>\n                    Hypercalcaemia of malignancy (HCM) is a recognised paraneoplastic complication of advanced cancer, with HHM being mediated predominantly by parathyroid hormone-related protein (PTHrP) secretion. While commonly observed in squamous cell carcinomas, it is exceedingly rare in gallbladder adenocarcinoma, with only isolated case reports described in the literature. We report a man in his 50s with metastatic gallbladder cancer who presented with colicky abdominal pain, constipation, fatigue, low mood, delayed responses and insomnia. Delirium was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders- 5\n                    <jats:sup>th<\/jats:sup>\n                    Edition criteria. Laboratory evaluation revealed severe hypercalcaemia with a corrected serum calcium of 18.92 mg\/dL, suppressed parathyroid hormone of 7.83 pg\/mL and markedly elevated PTHrP of 701.3 pg\/mL, consistent with HHM. His condition improved with intravenous hydration, bisphosphonates and calcitonin, along with multidisciplinary palliative care addressing psychological, emotional and spiritual concerns. This case highlights the need to recognise hypercalcaemia as a potential cause of delirium, even in rare malignancies, as timely diagnosis may facilitate prompt symptom management and prevent potentially life-threatening complications.\n                  <\/jats:p>","DOI":"10.25259\/ijpc_150_2026","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T06:24:52Z","timestamp":1787293492000},"page":"328-331","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Humoral Hypercalcaemia in Metastatic Gallbladder Cancer Presenting as Delirium: A Case Report"],"prefix":"10.25259","volume":"32","author":[{"given":"Ajila","family":"Ajithkumar","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamali","family":"Poojary","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayita","family":"Deodhar","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raghu Sudarshan","family":"Thota","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"10.25259\/IJPC_150_2026\/ref-1","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1200\/JOP.2016.011155","article-title":"Cancer-related hypercalcemia","volume":"12","author":"Goldner","year":"2016","journal-title":"J Oncol Pract"},{"key":"10.25259\/IJPC_150_2026\/ref-2","first-page":"789","article-title":"Case records of the Massachusetts general hospital-case 39061","volume":"225","author":"Albright","year":"1941","journal-title":"N Engl J Med"},{"key":"10.25259\/IJPC_150_2026\/ref-3","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1038\/s41572-020-00236-z","article-title":"Delirium","volume":"6","author":"Wilson","year":"2020","journal-title":"Nat Rev Dis Primers"},{"key":"10.25259\/IJPC_150_2026\/ref-4","doi-asserted-by":"publisher","first-page":"2091","DOI":"10.1002\/cam4.749","article-title":"Prevalence of 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Gastroenterol"},{"key":"10.25259\/IJPC_150_2026\/ref-8","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1016\/j.clcc.2014.06.006","article-title":"Squamous cell carcinoma of the sigmoid colon presenting with severe hypercalcemia","volume":"13","author":"Ngo","year":"2014","journal-title":"Clin Colorectal Cancer"},{"key":"10.25259\/IJPC_150_2026\/ref-9","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1007\/s12328-023-01841-7","article-title":"Adenosquamous carcinoma of the gallbladder simultaneously producing granulocyte-colony-stimulating factor and parathyroid hormone-related protein","volume":"16","author":"Yanagi","year":"2023","journal-title":"Clin J Gastroenterol"},{"key":"10.25259\/IJPC_150_2026\/ref-10","doi-asserted-by":"publisher","first-page":"e52951","DOI":"10.7759\/cureus.52951","article-title":"Parathyroid hormone-related peptide-producing gallbladder cancer presenting with humoral hypercalcemia of malignancy: A case 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