Severe hypercalcemia complicated by acute pancreatitis revealing generalized bone lysis metastasis: Case report and review

Malignant hypercalcemia is a frequent metabolic complication of osteophilic tumors, exceptionally revealing cavitary cancer, but its prognosis remains poor despite early and adequate management. We report the case of a young patient, smoker without any previous history, admitted for the management of a digestive symptoms made of abdominal pain with food vomiting. The patient had an electrocardiogram withchest computed tomography scan and BBC evoking PA on malignant hypercalcemia. An etiological investigation was conducted to confirm the tumoral origin of the hypercalcemia. We put the patient on hyperhydration with corticotherapie and biohosphonates with a good clinical and biological improvement. Malignant hypercalcemia affects about 10%-20% of patients with cancer including nasopharyngeal carcinoma. Its clinical presentation varies according to the extent and speed of onset, responsible for multivisceral involvement including kidney, heart, neuropsychiatric system, which may engage the patient's vital prognosis. The therapeutic management is based on 4 main principles; hyperhydration, increase of urinary calcium excretion by loop diuretics, decrease of bone resorption by biphosphonates and extrarenal purification which remains the ideal choice in case of life-threatening severe hypercalcemia. Acute hypercalcemic pancreatitis as a mode of revelation of cavum cancer has almost never been described in the literature