Organic anxiety in a woman with breast cancer receiving denosumab

Hypocalcemia can induce heterogeneous psychiatric manifestations, and its etiology can be multifactorial. Herein, we describe a patient who had previously undergone resection of parathyroid glands, who presented with extreme anxiety and hypocalcemia after denosumab treatment for cancer-related bone metastasis. The anxiety subsided soon after correction of her serum calcium level. When denosumab is prescribed for patients with predisposing factors of hypocalcemia, such as hypoparathyroidism, clinicians should be aware of symptomatic hypocalcemia.