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A 38-year-old farmer having a brief history of weight loss and epigastric pain developed severe hypercalcemia culminating in an acute crisis necessitating urgent hospitalization. He was disoriented, severely dehydrated, and had a tender hepatomegaly. Investigations revealed hepatocellular carcinoma (HCC) on the top of cirrhosis of liver, severe hypercalcemia with suppressed PTH, and pre-renal azotemia. Finally, he was diagnosed with paraneoplastic hypercalcemia related to PTH-related peptide secretion from HCC. This is a unique case of paraneoplastic hypercalcemia arising out of epithelial carcinoma, and the review literature highlights the feature of hypercalcemia of malignancy.

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A 38-Year-Old Farmer Presented with Epigastric Pain and Drowsiness

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  • 发表日期：

    2025年

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  • Sharmin Jahan

摘要

A 38-year-old farmer having a brief history of weight loss and epigastric pain developed severe hypercalcemia culminating in an acute crisis necessitating urgent hospitalization. He was disoriented, severely dehydrated, and had a tender hepatomegaly. Investigations revealed hepatocellular carcinoma (HCC) on the top of cirrhosis of liver, severe hypercalcemia with suppressed PTH, and pre-renal azotemia. Finally, he was diagnosed with paraneoplastic hypercalcemia related to PTH-related peptide secretion from HCC. This is a unique case of paraneoplastic hypercalcemia arising out of epithelial carcinoma, and the review literature highlights the feature of hypercalcemia of malignancy.