HYPERCALCEMIA in A PARATHYROID CANCER

demo
Published on Jul 4, 2021
55 YEAR old male with metastatic parathyroid cancer and liver and bone metastases - calcium is 15 range , creat is 1.6 range lung clear, no edema, with no significant bony pain - started on iv fluids, aredia iv and calcitonin, 3 weeks later persisting hypercalcemia with serum calcium of 12.5 - next step in management ?
1) surgical resection of parathyroid tumor for debulking
2) start prolia
3) start sensipar
4) start radiation to bone mets

SCROLL BELOW FOR ANSWER
XXXXXXXXXXXXXXXXXXXXXX



1) surgical resection of parathyroid tumor for debulking - NO CURATIVE SINCE ALREADY METSTATIC
2) start prolia - USED IF INTOLERANCE TO SENSIPAR DUE TO NAUSEA OR EMESIS.
3) start sensipar - RIGHT ANSWER - CHOICE OF TREATMENT FOR REFRACTORY HYPERCALCEMIA TO BIPHOSPHONATES
4) start radiation to bone mets - NO RISK OF FRACTURE AT THIS TIME AND ALSO NOT IN PAIN - NO NOT RIGHT ANSWER