Clinical Study of Hypercalcemia in Patients with Hepatocellular Carcinoma
摘要
From January 1987 to December 1988, 12 of 630 consecutive patients with hepatocellular carcinoma (HCC) were found to be associated with hypercalcemia. Ten of these 12 patients had tumors involvement in both lobes of the liver. Ten patients were noted to have hypercalcemia when HCC was first diagnosed, while the remaining 2 patients developed hypercalcemia 3 months after the diagnosis of HCC. Clinical manifestations of hypercalcemia were nonspecific, including anorexia, constipation, somnolence, and depression. These symptoms were often mixed and obscured with the symptoms of HCC. The serum calcium level of these 12 patients ranged from 11.3mg/dl to 16.3mg/dl (mean±SD: 13.6±2.7mg/dl). Whole body bone scanning did not show extensive bony metastasis in any one of them. All but one patient showed decreased serum parathyroid hormone level, while the serum 1,25(OH)2 vitamin D level varied. Five patients received supportive treatment with intravenous fluid, furosemide, and hydrocortisone, 2 other patients received calcitonin injection, and another one patient received chemotherapy with epirubicin infusion. The results of these treatments were fair and transient. The median survival of these 12 patients was 2 months, most of them died of hepatic failure and upper gastrointestinal bleeding.