Acute Pancreatitis Due to Hypercalcemia Related to Bone Metastasis from Breast Cancer

A 48-year-old woman had infiltrating ductal cell carcinoma of left breast status post modified radical mastectomy 7 years ago. About 2 years ago, prior to this presentation, she had severe lower back pain, particularly at night. Breast cancer with sacrum and lumbar spinal metastases was found from the examination of Tc-99m whole-body bone scan. Radiotherapy and chemotherapy with adriamycin and cyclophosphamide were prescribed. One month before admission, new-onset tenderness over the left forearm and multiple bone pain progressed, and the repeat Tc-99m whole-body bone scan disclosed increased uptake found in the left humeral head, left tibia tuberosity, L2 spine, lower half of right femoral shaft and left hip joint. However, she had not received any chemotherapy during this month. One month later, she presented to our emergency department with severe epigastric pain, poor appetite and persistent vomiting. Upon arrival, physical examinations showed oral temperature of 38.4°C, pulse rate of 112/min, respiratory rate of 26/min and tenderness of epigastric …