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Syndromes of apparent hormone overproduction have been known to be associated with malignancies since the 1920s (7,2). Foremost among the endocrine conditions in patients with cancer is hypercalcemia, estimated to occur in at least 10 % of patients with advanced cancer (3). The differential diagnosis of hypercalcemia, while broad, most often comes down to a choice between primary hyper-parathyroidism or a malignant neoplasm, especially renal cell carcinoma, breast carcinoma, and squamous cell carci-noma in general and lung carcinoma in particular. In patients with cancer, the hypercalcemia results either from osteolytic metastases of the tumor due to local release of calcium by the bone-invading cells or from tumor-produced factors se-creted systemically that stimulate osteoclastic bone resorp-tion in patients with nonmetastatic tumors