Parathyroid hormone independent hypercalcemia in the setting of non metastatic leiomyosarcoma

Abstract

Background: We present an atypical case involving humoral hypercalcemia of malignancy arising in a patient with non-metastatic leiomyosarcoma. Cases of hypercalcemia of unknown source should prompt suspicion for rare tumors.

Case: A 56 year old woman requires hospitalization for hypercalcemia with low intact parathyroid hormone where renal ultrasound incidentally reports a uterine fibroid. Previous workup for a 9 month history of postmenopausal vaginal bleeding was found to be negative. Bone scan, computed tomography chest, mammogram, ultrasound of thyroid were negative. Dilatation and curettage revealed leiomyosarcoma. Hysterectomy causes complete resolution of her hypercalcemia.

Conclusions: Parathyroid hormone independent hypercalcemia in the setting of uterine mass should raise suspicion for paraneoplastic syndrome with biochemical and surgical workup to exclude leiomyosarcoma.