Hypercalcemia in patients with cancer is a common laboratory finding affecting up to 44% of that patient population. 1,25-Dihydroxyvitamin D3 mediated hypercalcemia is one of the rare mechanisms of this endocrine emergency in cancer patients. It is even rarer for solid organ neoplasms to present with hypercalcemia mediated through the production of 1,25-dihydroxyvitamin D3. We report a case of a 77-year-old female who presented to the hospital with hypercalcemia and later was found to have metastatic gastrointestinal stromal tumor. There have been only 5 cases of gastrointestinal stromal tumor described in literature resulting in hypercalcemia. In our case, the mechanism of hypercalcemia was thought to be related to overproduction of 1,25-dihydroxyvitamin by tumor cells. The patient had a favorable response to imatinib with normalization of serum calcium level. Unfortunately, she developed fluid retention due to imatinib which was discontinued resulting in relapse of hypercalcemia that was resistant to all other treatment options.

No abstract

No abstract

No abstract

INTRODUCTION Mucormycosis manifests in a variety of different clinical presentations in humans, particularly in immunocompromised patients and those with diabetes mellitus. 1 The agents of mucormycosis are common in the environment and can be found on decaying vegetation and in the soil. 2 All humans have ample exposure to these fungi during day-today activities. The fact that mucormycosis is a rare human infection reflects the effectiveness of the intact human immune system. This is supported by the finding that almost all human infections, due to the agents of mucormycosis, occur in the presence of some underlying compromising condition. We report a case of devastating rhino-orbital mucormycosis in a patient with uncontrolled diabetes resulting in exenteration of the left eye. Prognosis is poor for patients with brain, cavernous sinus, or carotid involvement. 3-5 Hence, it is important to make an early diagnosis and initiate appropriate treatment, along with strict glycemic control in diabetics, to decrease morbidity and mortality. CASE REPORT A 67-year-old male with stage IV chronic kidney disease, sleep apnea, coronary artery disease status post coronary artery bypass graft, and uncontrolled diabetes mellitus presented to an outside hospital with headache, nasal congestion, diplopia, and photophobia. The patient had invasive fungal sinusitis and underwent endoscopic sinus surgery and debridement. Cultures grew Rhizopus. The patient was transferred to our hospital after he became blind in the left eye (reportedly the night prior to transfer) for further aggressive management with endoscopic sinus surgery for debridement of invasive fungal sinusitis. On exam, the patient had proptosis of the left eye. He had left afferent pupillary defect, severely restricted gaze, and decreased