Some mechanisms...
1. Direct metastases to bone: These mets trigger the production of inflammatory cytokines and stimulate ostoclasts. Sometimes osteoclasts are directly stimulated by tumor cells via Osteoclast Activating Factors (eg IL6) in multiple myeloma or lymphoma.
2. PTH related peptide: this is the most common cause of hypercalcemia from non-metastatic solid tumors. Classically in squamous cell lung Ca
3. PTH: this is rare! only a few case reports of PTH being released from tumors
4. Calcitriol: a very common mechanism for hypercalcemia in the lymphomas.
a great article here
http://content.nejm.org/cgi/content/full/352/4/373
a great article here
http://content.nejm.org/cgi/content/full/352/4/373
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