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Clinical Case Volume 13 Issue 2
Severe hypercalcemia due to the coexistence of multiple myeloma and primary hyperparathyroidism. A rare association
Clara Casella, Eloisa Rivas, Beatriz Mendoza, Gabriela Mintegui
Received: July 24, 2025 | Published: August 4, 2025
Citation: Casella C, Rivas E, Mendoza B, et al. Severe hypercalcemia due to the coexistence of multiple myeloma and primary hyperparathyroidism. A rare association. Endocrinol Metab Int J. 2025;13(2):41-44. DOI: 10.15406/emij.2025.13.00369
Abstract
The presence of hypercalcemia in hospitalized patients is usually a consequence of
malignant tumors. Among these, multiple myeloma (MM) causes elevated calcium levels
due to increased bone resorption mediated by cytokines, which stimulate osteoclast activity.
Immobility and renal failure may also contribute. However, primary hyperparathyroidism
(PHP) is the most common cause of hypercalcemia in outpatients. However, there are few
reports on the association of HPP and MM.
We present the case of a hospitalized woman diagnosed with multiple myeloma who,
despite onco-specific treatment, persisted with elevated calcium levels. For this reason,
a lesion association was sought, and primary hyperparathyroidism was diagnosed.
Parathyroid scintigraphy identified a high uptake image, leading to surgical treatment. A
parathyroidectomy was performed, and serum calcium levels normalized. The pathology
report revealed hyperplasia.
This case highlights the importance of a thorough etiological evaluation in patients with
persistent severe hypercalcemia.
Keywords: hyperparathyroidism, severe hypercalcemia, vitamin D, multiple myeloma
©2025 Casella, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.