Humoral Hypercalcaemia in Metastatic Gallbladder Cancer Presenting as Delirium: A Case Report.

Authors

Ajila Ajithkumar, Shamali Poojary, Jayita Deodhar, Raghu Sudarshan Thota

Published in

Indian journal of palliative care. Volume 32. Issue 3. Pages 328-331. Epub Aug 21, 2026.

Abstract

Hypercalcaemia of malignancy (HCM) is a recognised paraneoplastic complication of advanced cancer, with HHM being mediated predominantly by parathyroid hormone-related protein (PTHrP) secretion. While commonly observed in squamous cell carcinomas, it is exceedingly rare in gallbladder adenocarcinoma, with only isolated case reports described in the literature. We report a man in his 50s with metastatic gallbladder cancer who presented with colicky abdominal pain, constipation, fatigue, low mood, delayed responses and insomnia. Delirium was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders- 5^th Edition criteria. Laboratory evaluation revealed severe hypercalcaemia with a corrected serum calcium of 18.92 mg/dL, suppressed parathyroid hormone of 7.83 pg/mL and markedly elevated PTHrP of 701.3 pg/mL, consistent with HHM. His condition improved with intravenous hydration, bisphosphonates and calcitonin, along with multidisciplinary palliative care addressing psychological, emotional and spiritual concerns. This case highlights the need to recognise hypercalcaemia as a potential cause of delirium, even in rare malignancies, as timely diagnosis may facilitate prompt symptom management and prevent potentially life-threatening complications.

PMID:
42694827
Bibliographic data and abstract were imported from PubMed on 04 Sep 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.