An elderly man was admitted to the hospital with a large squamous cell carcinoma involving the right side of the chest wall. The patient was severely confused, and evaluation revealed pronounced hypercalcemia. With total surgical removal of the tumor, the serum calcium level fell to normal and his confusion cleared. Although hypercalcemia has been reported in association with a number of malignant tumors, including metastatic squamous cell carcinoma, this finding has been encountered only rarely with squamous cell carcinoma localized to the skin. The secretion of transforming growth factor or of another humoral substance has been postulated as the possible cause of hypercalcemia in this patient.
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