Hypercalcaemia of malignancy: two primaries in the same patient.

Hypercalcaemia of malignancy (HCM) is a grave emergency in a cancer patient. Metastatic breast cancer and multiple myeloma are two of its important causes. Moreover, breast cancer is a predisposing factor for secondary malignancy, multiple myeloma being one of them. We report an interesting case of HCM in which we labelled the first two admissions to metastatic breast cancer. However, on third admission again for HCM, we diagnosed a coexisting multiple myeloma. As early diagnosis is the crux to decrease morbidity and prolong survival in HCM, this case emphasises the fact that more than one malignant cause can exist in the same patient. 2014 BMJ Publishing Group Ltd.