A 64 year old man with a 50 pack year smoking history presents with weight loss, cough, constipation, and confusion. Chest imaging reveals a hilar mass. Laboratory studies show calcium 13.8 mg per dL, suppressed parathyroid hormone, and normal 25 hydroxyvitamin D. Which of the following is the most likely mechanism of his hypercalcemia?
- A)Tumor secretion of PTH related peptideGABARITO
- B)Primary hyperparathyroidism from MEN syndrome
- C)Destruction of parathyroid glands by metastases
- D)Autoantibodies activating the calcium sensing receptor
- E)Excess calcitonin secretion by the tumor
Explicação
Squamous cell carcinoma of the lung classically causes paraneoplastic hypercalcemia by secreting PTH related peptide. The elevated calcium with suppressed native PTH and a hilar smoking related lung mass strongly support this mechanism. Ver explicação completa e trilha adaptativa →