PTHLH and Hypercalcemia: Three of them were considered to develop humoral hypercalcemia (high PTHrP level), whereas one patient resembling normal PTHrP was believed to have hypercalcemia related with tumor synthesis of osteoclast-activating factors [interleukin (IL)-1, IL-6, tumor necrosis factor-α, and prostaglandins] (3,21).