When is surgery indicated in the treatment of hypercalcemia?

Updated: Oct 03, 2018
  • Author: Mahendra Agraharkar, MD, MBBS, FACP, FASN; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Surgical care is directed toward reversing the underlying cause of hypercalcemia or repairing the orthopedic damage, as follows [20, 21] :

  • Prolonged hypercalcemia due to hyperparathyroidism may warrant surgical neck exploration and removal of one or more parathyroid glands; this is particularly appropriate if evidence of nephrolithiasis, osteoporosis, reduction of renal function, neuromuscular symptoms, or radiographic bone disease is present

  • Hypercalcemia due to malignancy, especially a tumor that is producing parathyroid hormone – related peptide (PTHrP), may necessitate surgical resection of the tumor

  • Orthopedic complications of prolonged hypercalcemia (eg, osteoporosis), complications of Paget disease, or complications of bony metastases may require orthopedic or neurosurgical intervention


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