August 1968

Massive Extraskeletal Calcification During Phosphate Treatment of Hypercalcemia

Author Affiliations


From the departments of medicine, Harvard Medical School (Drs. Carey and Kantrowitz), Tufts University School of Medicine (Dr. Schmitt), Massachusetts; General Hospital, and Boston Veterans Administration Hospital, Boston. Dr. Kopald is on active duty with the US Navy.

Arch Intern Med. 1968;122(2):150-155. doi:10.1001/archinte.1968.00300070054010

Although hypercalcemia is a frequent complication of neoplastic disease,1-4 extensive extraskeletal calcification has been described only rarely.5 Recently, inorganic phosphate therapy has been reported to lower serum calcium levels effectively and rapidly in hypercalcemic patients; its mechanism of action has not been well established. We have studied a patient with disseminated carcinoma and hypercalcemia who was treated with inorganic phosphate and who at postmortem examination demonstrated extensive soft tissue calcification. Because the degree of metastatic calcification was extreme and occurred following repeated phosphate administration, we are reporting this case.

Patient Summary  A 40-year-old white restaurant owner was admitted to the Massachusetts General Hospital on Oct 2, 1966, because of an enlarging painless leftsided neck mass first noted a month previously. In the week prior to admission, he had developed weakness, malaise, and occasional feverishness. Three days prior to admission, the patient had a serum calcium of 10.7 mg/

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