Hypercalcemia and Acute Kidney Injury in a Case of Angiosarcoma

Abstract

Hypercalcemia can be due to various disorders and may be associated with a spectrum of clinical manifestations, ranging from few (if any) symptoms in patients with mild and chronic hypercalcemia to obtundation and coma with severe hypercalcemia. We report a case of a 64-year-old male admitted to our emergency room for an altered mental state, severe hypercalcemia (serum calcium 17,5 mg/dl) and Acute Kidney Injury (AKI) treated with loop diuretics, fluid infusion and bisphosphonates with normalization of calcium, improvement of renal function and subsequent discovery of a bleeding lesion in the right inguinal region diagnosed as epithelioid angiosarcoma with osteolytic metastases. Angiosarcoma is a rare and highly aggressive malignant tumour originating from lymphatic or vascular endothelial cells. It makes up less than 2% of all soft tissue sarcomas and can occur in any organ with a high rate of local recurrence and metastasis [1]. Tumour-induced hypercalcemia is a frequent complication of advanced cancers, but it has been rarely reported in patients with angiosarcoma. Although this type of neoplasm diagnosis is often late and carried out in the most advanced states, we report a particular mode of presentation of angiosarcoma in this clinical case. We emphasize the necessity of screening for the potential existence of neoplasms for patient