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IntroductionLung cancer is the leading cause of death among the cancers seen in the United States. Hypercalcemia and leukocytosis are two common paraneoplastic syndromes associated with lung cancer. Unfortunately patients presenting with Hypercalcemia- leukocytosis syndrome has a worse prognosis than patients presenting with lung cancer alone.Case presentationWe present a 67 yr old Caucasian male with a history of active smoking presenting as pneumonia being diagnosed as cavitating squamous cell carcinoma of the lung with hypercalcemia-leukocytosis syndromeConclusionThere should be a high degree of suspicion to diagnose lung cancer in patients presenting with symptoms of paraneoplastic syndrome.

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Allergic bronchopulmonary aspergillosis (ABPA), seen in 3% to 5% of the asthmatic population, is a hypersensitivity disease of the lungs characterized by a type I, type III, and type IV allergic response to Aspergillus antigens, almost always to that of A. fumigatus. If untreated, permanent lung damage in the form of bronchiectasis and fibrosis ensues. Recurrent pulmonary opacities on chest radiography, peripheral blood eosinophilia, and refractory asthma should raise suspicion for ABPA. A positive skin test for A. fumigatus and elevated levels of serum IgE strongly suggest the diagnosis of ABPA. The demonstration of central bronchiectasis is also highly suggestive of ABPA, particularly when high attenuation mucoid impaction is encountered. Corticosteroid therapy remains the cornerstone of treatment.