Hypercalcemia Of Malignancy (in Under 10)

Hypercalcemia of malignancy, its causes, and treatment are discussed, emphasizing its relevance as an oncologic emergency. Hypercalcemia is defined as a corrected calcium level above 10, with levels above 14 considered severe. Common cancers associated with it include multiple myeloma, renal cell carcinoma, lung, and breast cancer. The two main mechanisms are the secretion of parathyroid hormone-related peptide by squamous cell carcinomas and cytokine-induced osteoclast activity in cancers like multiple myeloma. Treatment involves aggressive IV fluid administration to dilute calcium and address dehydration, followed by bisphosphonates to decrease osteoclast activity, and calcitonin for immediate calcium level reduction in severe cases.