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Case Reports in Medicine
Volume 2014 (2014), Article ID 246817, 4 pages
Case Report

Cholangiocarcinoma Presenting with Hypercalcemia and Thrombocytopenia

1General Surgery Department, Sisli Etfal Teaching and Research Hospital, Sisli, 34173 Istanbul, Turkey
2Arnavutkoy Government Hospital General Surgery Department, Arnavutkoy, 34555 Istanbul, Turkey
3Pathology Department, Sisli Etfal Teaching and Research Hospital, Sisli, 34173 Istanbul, Turkey
4Medipol University Hospital General Surgery Department, Bagcılar, 34214 Istanbul, Turkey
5Bezmi Alem University Hospital General Surgery Department, Fatih, 34093 Istanbul, Turkey

Received 29 January 2014; Revised 25 May 2014; Accepted 26 May 2014; Published 15 June 2014

Academic Editor: Thomas J. Vogl

Copyright © 2014 Muharrem Battal et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Malignant hypercalcemia and thrombocytopenia may result from bone metastasis of cholangiocarcinoma (CC). Our case was 53-year-old man admitted to emergency department with symptoms of anorexia, weight loss, nausea, vomiting, and general fatigue in February 2012. His laboratory findings showed hypercalcemia and thrombocytopenia. CT showed a large multinodular mass in the right lobe and, extending through left lobe of the liver. We considered the diagnosis of hypercalcemia of malignancy with elevated calcium levels and suppressed PTH level with the existence of skeletal bone metastasis and the absence of parathyroid gland pathology. Treatment of hypercalcemia with IV saline, furosemide, and calcitonin improved the patient symptoms. After the 8th day of admission, calcium level, thrombocytopenia, and other symptoms were normalized. Patient was sustained surgically inoperable and transferred to medical oncology department for the purpose of palliative chemotherapy and intended radiotherapy for bone metastasis. Hypercalcemia relapsed 4 weeks after discharge and patient died at the 5th month after admission due to disseminated metastasis. We should be aware of CC with symptomatic hypercalcemia and rarely low platelet count. The correction of hypercalcemia provides symptomatic relief and stability of patients.