Double Trouble: A Unique Case of Hypercalcemia Caused by Two Underlying Etiologies

Cureus. 2022 Jan 10;14(1):e21084. doi: 10.7759/cureus.21084. eCollection 2022 Jan.

Abstract

Hypercalcemia has a variety of causes, with primary hyperparathyroidism and malignancies being the most frequently reported. We present the case of a patient presenting with chronic abdominal pain, constipation, and weight loss who was found to have hypercalcemia. The patient was initially diagnosed with colonic actinomycosis, but further investigations revealed an intra-abdominal diffuse large B-cell lymphoma (DLBCL). We suspect that the leading cause of hypercalcemia was the DLBCL, likely exacerbated by actinomycosis. Actinomycosis and DLBCL can have a similar presentation, so misdiagnosis or coexistence of both conditions should be suspected when a lack of response to one specific therapy is observed.

Keywords: colonic actinomycosis; diffuse large b lymphoma; granulomatous infection; hypercalcemia; occult malignancy.

Publication types

  • Case Reports