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December 1980

Unexplained Hypercalcemia

Arch Intern Med. 1980;140(12):1674. doi:10.1001/archinte.1980.00330230120029

To the Editor.  —We read with interest the report entitled "Cervical Carcinoma and Ectopic Hyperparathyroidism" in the April Archives (1980;140:569-571). We wish to report an additional case.

Report of a Case.  —A 35-year-old woman was admitted for weight loss of six weeks' duration. A diagnosis of epidermoid carcinoma of the cervix had been made ten months previously. She had a radical total hysterectomy and pelvic lymphadenectomy followed by cobalt therapy to the pelvic area. Physical examination showed a cachectic female. The liver was not enlarged. A rectovaginal fistula was present. The serum calcium level was elevated, ranging from 11.7 to 14.2 mg/dL. The serum phosphorus and the alkaline phosphatase levels were normal. Plasma immunoreactive parathyroid hormone (PTH) levels were 286 and 296 pg/mL on two occasions (serum calcium, 12.8 and 14.0 mg/dL, respectively). The range for normocalcemic controls for the laboratory (Upjohn) was 163 to 347 pg/mL. An intravenous pyelogram