Increase in serum 1,25-dihydroxyvitamin D and hypercalcaemia in a patient with inflammatory myofibroblastic tumour.
Hypercalcaemia complicates the clinical course of a substantial number of patients with advanced cancer. This report describes a patient with an inflammatory myofibroblastic tumour in soft tissue who developed an inflammatory reaction, hypercalcaemia, and a high serum concentration of 1,25 dihydroxyvitamin D. Serum concentrations of 25-hydroxyvitamin D, parathyroid hormone, and parathyroid hormone related protein were normal. Histological examination of the tumour revealed fibrosarcoma with abundant macrophage infiltration. mRNA for 25-hydroxyvitamin D-1alpha-hydroxylase was identified in the tumoral tissue. In view of this case, inflammatory myofibroblastic tumour should be added to the list of diseases that are responsible for vitamin D mediated hypercalcaemia.