We report a case of humoral hypercalcemia associated with a rapidly growing gastric carcinoma. To our knowledge, this is the first such case of gastric carcinoma reported with raised plasma parathyroid hormone related peptide (PTHrP) and absent bone metastases.

A 69 year old woman presented with fatigue and intermittent sharp epigastric pain for one week. Upper gastrointestinal radiographs and endoscopy demonstrated a necrotic, friable mass in the mid stomach. Biopsy of the mass and a surrounding satellite polypoid lesion showed poorly differentiated adenocarcinoma and gastric adenoma with high grade dysplasia, respectively (fig 1). Four weeks after the first symptoms had arisen the liver edge was …