Hypocalcemia as a presentation for multifocal osteosarcoma.

We report the case of a 16-year-old male with multifocal osteosarcoma presented with symptomatic hypocalcemia. The patient presented signs of hypocalcemia accompanied by generalized bone pain and a femoral mass. Further evaluation revealed secondary hyperparathyroidism, highly elevated alkaline phosphatase levels, and generalized sclerotic and lytic lesions. Biopsy confirmed osteosarcomatosis. Despite aggressive chemotherapy, he died from progressive disease 2 months after diagnosis. The course of disease in this patient suggests that hypocalcemia reflects a poor prognosis.