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In 32 patients with primary liver tumors incidence and etiology of hypercalcemia were evaluated. Two patients revealed hypercalcemia from osteolytic metastases, one had coexistent primary hyperparathyroidism and in one patient hypercalcemia was paraneoplastic. The last two patients are presented in detail by case reports. Differential diagnostic problems appear often in patients in bad general condition, since invasive diagnostic methods are limited. The most potent substance to treat acute hypercalcemic syndrome is mithramycin. In those cases where surgical treatment is possible, complete resection of the primary liver tumor or the adenoma of the parathyroid gland is recommended.
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