Two Operated Cases of Lung Cancer Showing Humoral Hypercalcemia of Malignancy (HHM)

Two cases of lung cancer and hypercalcemia (Case 1: 66-year-old male; adenocarcinoma, Case 2: 63-year-old male; squamous cell carcinoma) were diagnosed as humoral hypercalcemia of malignancy (HHM) based on the results of bone scintigram and the laboratory findings concerning Ca metabolism. In both patients hypercalcemia and disturbed consciousness improved transiently after administration of mithramycin and preoperative evaluation could be accomplished. A right upper sleeve lobectomy was performed in Case 1 (p-T3N0M0) and hypercalcemia temporarily disappeared postoperatively, but he died of metastases on the 73rd postoperative day. Thoracotomy in Case 2 revealed the tumor to be unresectable because of pleural dissemination (p-T4N2M1) and he died of hypercalcemia on the 18th postoperative day. In summary, in two lung cancer patients diagnosed as HHM operation was indicated but their prognoses were extremely poor.