Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
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Fatih Kilci
,
Uğur Demirsoy
,
Jeremy Huw Jones
,
Özgür Çakır
and
Filiz Mine Çizmecioğlu-Jones
Abstract
Objectives
Ectopic parathyroid hormone (PTH) secretion is rare in children with rhabdomyosarcoma, and only a few pediatric cases have been reported to date. Reports of the use of zoledronic acid (ZA) and Denosumab are limited for the treatment of hypercalcemia of malignancy (HCM) in the pediatric population. The aim of presenting this pediatric case of rhabdomyosarcoma accompanied by HCM, secondary to ectopic PTH secretion, was to highlight the benefits of ZA as a first-choice bisphosphonate in this situation with Denosumab as an alternative therapy.
Case presentation
The patient was diagnosed at 13 years with alveolar rhabdomyosarcoma. Multiple bone metastases first appeared at 15 years, but he remained normocalcemic until 17 years old when serum calcium was 15.1 mg/dL and PTH 249 pg/mL. While serum calcium responded well after ZA and Denosumab cycles, PTH remained elevated, reaching a peak value of 1851 pg/mL during treatment cycles.
Conclusions
We report a patient with rhabdomyosarcoma accompanied by HCM, secondary to ectopic PTH, in whom the HCM was successfully managed with ZA and Denosumab. We believe that ZA should be the bisphosphonate of choice in pediatric HCM with rhabdomyosarcoma, while Denosumab may be another option in ZA-refractory cases.
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Research funding: None declared.
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Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Informed consent was obtained from all individuals included in this study.
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Ethical approval: The local Institutional Review Board deemed the study exempt from review.
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Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
Articles in the same Issue
- Frontmatter
- Review Article
- Effects of vitamin D supplementation on glycemic control of children and adolescents with type 1 diabetes mellitus: a systematic review
- Original Articles
- A preliminary study on the relationship between environmental endocrine disruptors and precocious puberty in girls
- Tissue concentration of aldosterone in fetal adrenals of intrauterine death cases
- Complications of orthopedic treatment in patients diagnosed with X-linked hypophosphatemic rickets
- Comparison of insulin sensitivity indices for detection of double diabetes in Indian adolescents with type 1 diabetes
- Evaluation of the growth and nutritional status of preschool children: a pilot study in the cold area of China
- Arterial hypertension is associated with an increased risk of metabolic complications in pediatric patient with obesity
- From pregnancy to breastfeeding: adequate maternal body mass index is essential to prevent a high body mass index in your children
- Screening of non-syndromic early-onset child and adolescent obese patients in terms of LEP, LEPR, MC4R and POMC gene variants by next-generation sequencing
- The association between vitamin B12, folate, homocysteine levels, and carotid intima-media thickness in children with obesity: a cross-sectional study
- Comprehensive assessment of cardiovascular disease risk in children with short stature due to isolated growth hormone deficiency: a case-control study
- Visceral adiposity is related to insulin sensitivity and inflammation in adolescents with obesity and mild sleep disordered breathing
- Recurrent hypoglycemic seizure as a presenting symptom of post-TBI hypopituitarism in children: a case report, review and proposed protocol
- Evaluation of the etiological and clinical characteristics of pediatric central diabetes insipidus
- Case Reports
- Clinical and radiologic evaluation of a Turkish family with hypochondroplasia and a rare FGFR3 variant
- Rituximab therapy in ROHHAD(NET) syndrome
- Ectopic parathyroid hormone as a rare aetiology of hypercalcemia with rhabdomyosarcoma: a new treatment strategy with zoledronic acid and Denosumab
- A 2-bp deletion mutation in SMPD1 gene leading to lysosomal acid sphingomyelinase deficiency in a Chinese consanguineous pedigree
