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BACKGROUND: Primary hyperparathyroidism is the most common cause of hypercalcemia and is most frequently identified in early postmenopausal women with hypercalcemia and abnormal parathyroid hormone concentrations. CLINICAL CASE: A 62-year-old female patient who presented to the emergency room in a state of septic shock secondary to pyelonephritis due to extensive renal calcifications, antimicrobial and amine treatment was started, parathyroid hormone was requested, which was very high, and left nephrectomy was performed after exclusion by scintigraphy, with improvement but persistence of leukocytosis, procedures were performed for the study and treatment of pleural effusions, and a diagnosis of overlap syndrome was integrated with right ureterolithotripsy and later, parathyroidectomy. CONCLUSIONS: There are no established treatment guidelines for overlap syndrome. High-risk patients suitable for intensive treatment should be considered for allogeneic transplantation. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute pancreatitis is the most common gastrointestinal disease in hospital admissions. The predominant causes are: gallstones (40%), prolonged alcohol consumption (30%) and hypertriglyceridemia (2-5%). Other less frequent causes are related to drugs, trauma, ischemia, infections, autoimmune diseases, endoscopic retrograde cholangiopancreatography and hypercalcemia. CLINICAL CASE: A 54-year-old patient with acute pancreatitis associated to goiter, bilateral renal lithiasis, and hypercalcemia, with no important pathological history for the current disease. Therefore, a study protocol was performed as a reason for acute pancreatitis, finding primary hyperparathyroidism due to a parathyroid adenoma as cause of the acute disease. CONCLUSIONS: In this case, definitive surgery avoided acute complications, and could prevent disability and chronic or recurrent pancreatitis readmissions, that could lead the patient even to death. [ABSTRACT FROM AUTHOR]

BACKGROUND: Bone marrow fibrosis is characterized by increased deposition of reticulin fibers and, in some cases, collagen fibers. There is a series of hematological and non-hematological disorders that are associated with an increase in bone marrow fibrosis. Non-small cell lung cancer represents 85% of all cases of lung cancer. Bone metastasis is one of the most common complications among lung cancer survivors. Some patients with bone metastases may suffer pathological fracture, compression of the spinal cord or malignant hypercalcemia. CLINICAL CASE: A 57-year-old male patient with a history of diabetes mellitus and smoking, who presented with a clinical picture of low back pain of 4 months of evolution; at admission he had hypercalcemia, acute kidney injury, anemia and osteolytic lesions. A diagnostic approach of hypercalcemia of neoplastic origin was made. CONCLUSIONS: The approach of a patient with high suspicion of multiple myeloma was carried out, without being able to establish that diagnosis, for which reason an iliac crest biopsy and tomographic study were requested, documenting bone marrow fibrosis associated with metastatic pulmonary adenocarcinoma. [ABSTRACT FROM AUTHOR]

BACKGROUND: Acute hypercalcemia is a life-threatening condition that most commonly results from malignancy. Local osteolytic hypercalcemia (the local destruction of bone by tumor with calcium release) accounts for about 20% of cancer-related hypercalcemia. Destruction of bone by metastatic cancer is a late event, starting when tumor cells proliferate. Symptoms and complications of bone metastases (pain, pathologic fractures, compression of the spinal cord) become more evident as the disease becomes more extensive. CLINICAL CASE: A 27-year-old female patient that developed acute osteolysis following hypercalcemia of malignancy. CONCLUSIONS: What makes the present case unique was the rapid evolution of osteolysis during the hypercalcemic crisis, evidenced by computed tomography, in a temporality of only 14 days. [ABSTRACT FROM AUTHOR]

The endocrine or humoral paraneoplastic síndromes can be defined as clinical entities, caused by a distance effect of a tumor, independiently of the local effect of its metastases, thath ocurrs mediated by the ectopical production of hormonal peptides o their precursors, citokines and rarely by tiroid hormone or D vitamin. The endocrine paraneoplastic syndromes, are important clinic entities associated to many kind of tumors. The importance of the knowledge of this syndromes is the chance to make a early diagnostic of a previously undiagnosed oncologic entity, avoid the diagnostic mistake induced by this syndromes that can be the predominant clinical scenario, or can be useful for monitoring the evolution and response to the treatment of the neoplasm that originate them. In this review are considerated the next paraneoplastic syndromes: the inappropriate secretion of the antidiuretic hormone, the malignancy's hypercalcemia, hypoglycaemia, Cushing syndrome and acromegaly. [ABSTRACT FROM AUTHOR]