Human parathyroid hormone-related protein (PTHrP) mRNA was detected in all fresh cancer tissues consecutively obtained from 6 patients with humoral hypercalcemia of malignancy (HHM). The primary sites of the cancers in these cases were distributed among different organs including the lung, esophagus, kidney and ovary. PTHrP mRNA was undetectable in all 10 fresh cancer tissues obtained from normocalcemic patients. These results suggest PTHrP as a major cause of HHM.