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Humoral Hypercalcemia of malignancy is a common cause of hypercalcemia. This is typically associated with cancers of the head and neck and lung cancer. Case presentation: We describe a 75-year-old male with history of urothelial carcinoma since 2010 who presented with lethargy and acutely worsening weakness. His physical exam was unremarkable except for noted lethargy. Laboratory studies demonstrated elevated serum calcium with elevated serum PTHrP level. The patient's hypercalcemia respondeddoi:10.15761/crr.1000115 fatcat:wmhi4cgcrvbavoqgowqru6a34a