Hypercalcemia in a patient with malignant melanoma arising in congenital giant pigmented nevus. A case of increased serum level of parathyroid hormone-related protein.

We describe a 43-year-old Japanese female who developed hypercalcemia associated with malignant melanoma. The patient underwent three resections of tumors on her groin and buttock secondary to a bathing trunk congenital nevus, and the histopathological findings showed benign congenital nevi. At the age of 42 years, she developed a malignant melanoma under the giant pigmented nevus in her groin. Fourteen months after the diagnosis of melanoma, she developed metastases to the lung, para-aortic lymph nodes and bones accompanied by hypercalcemia resulting from a remarkable increase in the serum level of parathyroid hormone-related protein (PTHrP). The patient died from acute renal and respiratory failure. In addition, we analyzed serum levels of calcium and PTHrP in 19 patients with advanced malignant melanoma. Seven patients had hypercalcemia, and 3 had increased serum levels of PTHrP.