In solid neoplasms, the development of HM has been shown to be closely associated with the stage of the disease: a study of three hundred and seventy-six consecutive patients with primary oesophageal carcinoma treated at the National Cancer Center Hospital, Tokyo, from 1983 to 1988, demonstrated that only five patients (1.3%) with operable cancer presented with hypercalcaemia. Following surgery, serum calcium levels were normal in all five patients. In contrast, among one hundred and twenty patients whose serum calcium levels were evaluated within two months of death from advanced oesophageal carcinoma, forty-five (thirty-eight per cent) developed hypercalcaemia. In other types of neoplasm the same relationship was observed, indicating that this electrolyte imbalance develops mainly in patients with advanced cancers.
