Severe Hypocalcemia in a Patient with Recurrent Chondrosarcoma

Abstract

Hypocalcemia is relatively uncommon paraneoplastic syndrome. Only one case of hypocalcemia has been reported in a patient with chondrosarcoma. We herein report a case of a 32-year-old woman with metastatic chondrosarcoma with tetany. Her imaging findings revealed multiple calcific metastatic lesions in the lungs, pancreas, left atrium, and pulmonary vein. A laboratory examination showed hypocalcemia with no evidence of any other disease that could induce hypocalcemia. On the basis of the laboratory and clinical findings, we concluded the etiology of her severe hypocalcemia to be excessive calcium consumption by the tumor itself.

Keywords: chondrosarcoma; hypocalcemia; osteoblastic metastases.

Figure 1.

A biopsy of the recurred lesion showed features of mesenchymal chondrosarcoma. (A) Mesenchymal chondrosarcoma with chondroid areas (right), Hematoxylin and Eosin (H&E) staining, original magnification 100×. (B) Mesenchymal chondrosarcoma with undifferentiated small round cells, H&E staining, original magnification 200×. (C) Undifferentiated small round cells and cartilage differentiation, H&E staining, original magnification 1,000×.

Figure 2.

Chest X-ray image showing multiple spherical lesions in both lungs.

Figure 3.

Computed tomography scan showing multiple calcified metastatic lesions in the lung (A: white arrows), left atrium (B: black arrow), left pulmonary vein (C: black arrow head), and pancreas (D: white arrow head).

Figure 4.

Serial follow-up measurements of the patient’s calcium and inorganic phosphate levels.