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Cureus 2022 Apr 12;14(4):e24081. Epub 2022 Apr 12.

Hematology and Oncology, Pikeville Medical Center, Pikeville, USA.

Immobilization is an uncommon etiology of hypercalcemia. It is usually seen in conditions associated with limited movements such as spinal cord injuries, vascular events, or following prolonged hospitalization. Hereby, we present a case of a young patient who had prolonged hospitalization following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Read More

Int J Mycobacteriol 2022 Jan-Mar;11(1):113-115

Department of Internal Medicine, Aveiro Hospital Center, Portugal.

Pott's disease is a vertebral infection caused by Mycobacterium tuberculosis. Indolent nature and subacute course are associated with late diagnosis. A clinical case is presented whose diagnosis was delayed by atypical presentation with progressive worsening of symptoms. Read More

Asian Pac J Cancer Prev 2022 Feb 1;23(2):623-630. Epub 2022 Feb 1.

Division of Medical Oncology, Department of Internal Medicine, Buddhasothorn Hospital, Chachoengsao, Thailand.

Objective: Although many prognostic scoring systems have been used to predict survival of malignant spinal cord compression (MSCC) patients, some previous data have shown that the accuracy of the scoring system remains problematic. Current advanced cancer therapies may influence the altered survival predictions. The aim of this study was to develop a new prognostic scoring system for higher accuracy of survival prediction in patients with malignant spinal cord compression (MSCC). Read More

JAMA Netw Open 2021 07 1;4(7):e2118410. Epub 2021 Jul 1.

Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago.

BMJ Case Rep 2021 Jun 2;14(6). Epub 2021 Jun 2.

Internal Medicine, Amsterdam UMC Location VUmc, Amsterdam, The Netherlands

Hypercalcaemia due to immobilisation is an uncommon diagnosis and requires extensive evaluation to rule out common causes of hypercalcaemia such as primary hyperparathyroidism and malignancy.We report an unusual case of profound hypercalcaemia due to immobilisation in a young man due to acute spinal cord ischaemia, leading to paraplegia. Other causes of hypercalcaemia were ruled out and elevated bone turnover markers supported our hypothesis. Read More

Support Care Cancer 2021 Jul 6;29(7):4081-4088. Epub 2021 Jan 6.

Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan.

Purpose: The risk factors for skeletal-related events (SREs) among non-small cell lung cancer (NSCLC) patients during treatment with bone-modifying agents (BMAs) are not yet well-understood.

Methods: The medical records of 238 consecutive NSCLC patients treated with BMAs, including zoledronic acid and denosumab, at the Chiba University Hospital from 2012 to 2016 were reviewed in the present study. SREs were defined as either pathologic fractures, spinal cord compression, the need for bone irradiation or surgery, or hypercalcemia. Read More

Med Clin North Am 2020 May 14;104(3):525-538. Epub 2020 Feb 14.

Division of Palliative Medicine, University of Kansas Medical Center, Kansas City, KS, USA. Electronic address: https://twitter.com/ctsinclair.

Medical emergencies at the end of life require recognition of patients at risk, so that a comprehensive assessment and plan of care can be put in place. Frequently, the interventions depend on the patient's underlying prognosis, location of care, and goals of care. The mere presence of a medical emergency often rapidly changes an estimated prognosis. Read More

Am J Emerg Med 2020 11 10;38(11):2477-2481. Epub 2020 Mar 10.

Department of Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.

Ann Palliat Med 2020 May 2;9(3):1314-1323. Epub 2019 Sep 2.

Division of Medical Oncology, Sunnybrook Odette Cancer Centre, Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

Bone lesions from metastatic solid tumors and multiple myeloma (MM) represent an important source of morbidity in patients with incurable malignancies. Dysregulation of osteoclast and osteoblast activity caused by tumor cells in the bone microenvironment weakens the structural integrity of bone and predisposes to skeletal-related events (SREs), which can include severe bone pain, pathologic fracture, spinal cord compression and hypercalcemia. In order to reduce the risk of these complications, the supportive treatment of patients with bone lesions from advanced cancer typically includes the use of bone-modifying agents (BMAs), specifically bisphosphonates and denosumab. Read More

J Nippon Med Sch 2019 ;86(3):159-164

Department of Orthopaedic Surgery, Nippon Medical School.

Background: Early diagnosis of bone metastasis is difficult. The aim of the present study was to determine whether symptoms related to skeletal-related events (SREs) can be used for the diagnosis of bone metastasis in the absence of screening tests.

Methods: We reviewed 81 patients with bone metastasis to evaluate their SREs at diagnosis. Read More

Praxis (Bern 1994) 2018 Jul;107(14):749-754

1 Universitätsspital, Klinik für Innere Medizin, Basel.

CME: Multiple Myeloma - a Review Abstract. Multiple myeloma accounts for 1 % of all malignancies, and its incidence increases with age. Both the symptoms and the course of the disease are heterogeneous. Read More

BMJ Case Rep 2018 Jun 11;2018. Epub 2018 Jun 11.

Department of Endocrinology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India.

Osteoporosis is the most common metabolic bone disorder worldwide, especially in women. Postmenopausal status is the most common risk factor for osteoporosis in elderly women. The operational diagnosis of osteoporosis is usually made with the help of central dual energy X-ray absorptiometry scan. Read More

Medicine (Baltimore) 2017 Dec;96(51):e9327

The Second Affiliated Hospital of Harbin Medical University The Tumor Hospital Affiliated to Harbin Medical University, Harbin, China.

Because of improving treatments and survival, 40% to 58% of patients with bone metastases from nonsmall cell lung cancer (NSCLC) will suffer from at least one skeletal-related event (SRE), affecting their quality of life, but the natural history of SRE is poorly understood. The study aimed to examine the factors involved in SRE-free survival (SRS) and overall survival (OS) of patients with NSCLC and bone metastases.This was a retrospective study of 211 patients with bone metastasis from NSCLC and treated at the Tumor Hospital Affiliated to Harbin Medical University between January 2007 and January 2012. Read More

Bratisl Lek Listy 2017 ;118(9):529-534

Neuroendocrine tumors arise from various cells that form a part of the endocrine system and account for a small number of cases encountered by oncologists in clinical practice. The clinical incidence of these tumors used to be low, and newer imaging modalities have now begun to be used for detecting bone metastases at an earlier stage. Bone metastases arising from neuroendocrine tumors are a well-recognized complication. Read More

Curr Osteoporos Rep 2017 10;15(5):483-498

Center for Multiple Myeloma, Massachusetts General Hospital Cancer Center, Professional Office Building 216, 55 Fruit Street, Boston, MA, 02114, USA.

Purpose Of Review: Bone disease is a defining characteristic of multiple myeloma (MM) and the major cause of morbidity. It manifests as lytic lesions or osteopenia and is often associated with severe pain, pathological fracture, spinal cord compression, vertebral collapse, and hypercalcemia. Here, we have reviewed recent data on understanding its biology and treatment. Read More

Spinal Cord Ser Cases 2017 13;3:17010. Epub 2017 Apr 13.

Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Introduction: Immobilisation-induced hypercalcemia following SCI affecting the kidney function, is a rare but potentially serious condition. We report immobilisation-induced hypercalcemia affecting the kidney function in two young native Greenlanders with spinal cord injury (SCI).

Case Presentations: Two 15- and 24-year-old male native Greenlanders, both with traumatic C5 SCI were admitted to our spinal cord unit. Read More

Cochrane Database Syst Rev 2017 03 23;3:CD003347. Epub 2017 Mar 23.

Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Spain, Sant Antoni Maria Claret 171 - Edifici Casa de Convalescencia, Barcelona, Catalunya, Spain, 08041.

Background: This is an update of the review published in Issue 4, 2003. Bone metastasis cause severe pain as well as pathological fractures, hypercalcaemia and spinal cord compression. Treatment strategies currently available to relieve pain from bone metastases include analgesia, radiotherapy, surgery, chemotherapy, hormone therapy, radioisotopes and bisphosphonates. Read More

Int J Clin Oncol 2017 Jun 2;22(3):548-553. Epub 2017 Jan 2.

Department of Orthopedic Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1138655, Japan.

Background: The aim of the present study was to elucidate the details of bone metastasis (BM) and the resulting skeletal-related events (SREs), and survival and prognostic factors, in urothelial cancer (UC) patients with BM.

Methods: A total of 48 UC patients with BM who were treated at our institution between 1994 and 2013 were enrolled. Details of BM and SREs were investigated. Read More

Clin Ther 2016 Aug 29;38(8):1880-9. Epub 2016 Jul 29.

Xcenda, Palm Harbor, Florida. Electronic address:

Purpose: The development of skeletal-related events (SREs) (pathologic fracture, need for surgery and/or radiation to bone, spinal cord compression, and hypercalcemia of malignancy) in metastatic prostate cancer (MPC) is associated with worsened pain and compromised quality of life. Opioids are frequently used throughout the course of SRE treatment. This study describes the treatment patterns and incremental use of opioids in MPC patients diagnosed with SREs. Read More

Eur J Cancer Care (Engl) 2017 Nov 19;26(6). Epub 2016 Jul 19.

Department of Orthopedics, The First Affiliated Hospital, Shantou University Medical College, Shantou, Guangdong, China.

The purpose of this meta-analysis was to evaluate the efficacy of denosumab, compared with zoledronic acid (ZA), in delaying skeletal-related events (SREs) and enhancing overall survival in patients with advanced solid tumours and bone metastases. A systematic literature search of several electronic databases, including PubMed, Medline, Embase, the Cochrane Library, CKNI and Web of Science with Conference Proceedings, was performed. Only randomised controlled trials assessing denosumab in comparison with ZA, in patients with advanced solid tumours and metastatic-stage disease, were included. Read More

Oncology 2016 20;90(2):103-11. Epub 2016 Jan 20.

Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea.

Background/objective: The aim of this study was to evaluate the characteristics and prognostic factors of small cell lung cancer (SCLC) with bone metastases. We also investigated the characteristics and predictive factors of skeletal-related events (SREs) in these patients.

Materials And Methods: Sixty-one patients who were first diagnosed with SCLC with bone metastases at our institution were included in this retrospective analysis. Read More

J Med Econ 2016 22;19(5):477-86. Epub 2016 Jan 22.

a Eli Lilly and Company , Indianapolis , IN , USA.

Objective: A potential complication for all new multiple myeloma (MM) patients is the clinical presentation of osteolytic lesions which increase the risk for skeletal-related events (SREs). However, the contribution of SREs to the overall economic impact of MM is unclear. The impact of SREs on healthcare resource utilization (HCRU) and costs for US patients with MM was analyzed in Truven Health Marketscan Commercial Claims and Medicare Supplemental Databases. Read More

Medicina (B Aires) 2014 ;74(6):457-61

Instituto de Investigaciones Metabólicas (IDIM), Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador (USAL), Buenos Aires, Argentina. E-mail:

This report shows our conclusions on the clinical, biochemical and densitometry characteristics of 35 normocalcemic primary hyperparathyroidism (PHPT) patients. This condition is defined by a high level of intact parathyroid hormone (iPTHI) with persistently normal serum and ionized calcium in the absence of secondary hyperparathyroidism. Our selection consisted of 30 women (90%) and 5 men (10%). Read More

Support Care Cancer 2015 Jan 2;23(1):237-47. Epub 2014 Oct 2.

Partnership for Health Analytic Research, LLC, 280 S. Beverly Dr., Suite 404, Beverly Hills, CA, 90212, USA.

Purpose: Up to 75% of patients with prostate cancer experience metastatic bone disease, which leads to an increased risk for skeletal-related events (SREs) including pathological bone fracture, spinal cord compression, and hypercalcemia of malignancy. Our objective was to systematically review the literature on the impact of SREs on quality of life (QOL), morbidity, and survival with a primary focus on the impact of SREs on pain in prostate cancer patients.

Methods: We searched PubMed, limiting to peer-reviewed English-language human studies published in 2000-2010. Read More

J Thorac Oncol 2014 Feb;9(2):231-8

*Institute of Biomedical Research and Innovation, Kobe, Japan; †Yokohama Municipal Citizen's Hospital, Yokohama, Japan; ‡Osaka City General Hospital, Osaka, Japan; §Kyushu University Hospital, Fukuoka, Japan; ‖Gifu Municipal Hospital, Gifu, Japan; ¶Aichi Cancer Center Aichi Hospital, Okazaki, Japan; #National Hospital Organization Hokkaido Cancer Center, Sapporo, Japan; **Toneyama National Hospital, Toyonaka, Japan; ††Tokai University School of Medicine, University Hospital, Isehara, Japan; ‡‡Shizuoka Cancer Center, Shizuoka, Japan; §§The University of Tokyo, Tokyo, Japan; and ‖‖Teikyo University School of Medicine, Tokyo, Japan.

Background: Bone metastasis (BM) is a frequent complication in patients with advanced lung cancer and it causes skeletal-related events (SREs). Our study aim is to prospectively investigate the incidence of BM, incidence and types of SRE, and predictive factors of BM and SREs.

Methods: Newly diagnosed, advanced non-small-cell lung cancer (NSCLC) or small-cell lung cancer (SCLC) patients were enrolled into the study. Read More

Bull Cancer 2013 Nov;100(11):1073-81

Institut Curie, hôpital René-Huguenin, 35, rue Dailly, 92210 Saint-Cloud, France.

The actual improvement of epidemiologic database collection concerning bone metastases of solid tumors allows us to better understand the seriousness of this evolution, its human, social and financial burden. A renewal of interest appeared with a better screening of the asymptomatic forms and by the therapeutic advances obtained by bone resorption inhibitors. They were developed in clinical trials with a specific and original methodology evaluating their efficacy on the skeletal-related events (SRE) (pain, fracture, spinal cord compression, pathologic fracture and hypercalcemia). Read More

Hematol Oncol 2014 Mar 1;32(1):52-5. Epub 2013 Sep 1.

Clinical Haematology, University College Hospital, London, UK.

Orthop Nurs 2013 Jul-Aug;32(4):209-14; quiz 215-6

University Hospitals Case Medical Center, Seidman Cancer Center, Cleveland, OH, USA.

Bone is the third most common site of cancer metastasis resulting in pain and other serious morbidities that can affect one's quality of life. The orthopaedic patient with bone metastasis faces many challenges and has complex nursing care needs. Managing care involves astute assessment skills, knowledge of treatments including medication, surgery, and radiation therapy, and recognition of serious complications such as fracture, spinal cord compression, and hypercalcemia. Read More

Expert Rev Pharmacoecon Outcomes Res 2013 Aug 18;13(4):483-96. Epub 2013 Jul 18.

Pharmerit International, Bethesda, MD 20814, USA.

Despite effective skeletal-related event (SRE)-limiting therapies such as zoledronic acid and denosumab, SREs continue to place a meaningful burden on patients, providers and payers. However, studies of SRE-related effects on clinical (i.e. Read More

Asian Pac J Cancer Prev 2013 ;14(5):3357-62

Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia.

The human skeleton is the most common organ to be affected by metastatic cancer and bone metastases are a major cause of cancer morbidity. The five most frequent cancers in Malaysia among males includes prostate whereas breast cancer is among those in females, both being associated with skeletal lesions. Bone metastases weaken bone structure, causing a range of symptoms and complications thus developing skeletal-related events (SRE). Read More