A 62-year-old woman presented to clinic for a second evaluation. Previously healthy, she initially presented for care several months earlier with anasarca. Initial workup was notable for normal renal function, calcium level, and liver function tests, no proteinuria, and echocardiogram demonstrating mild diastolic dysfunction and concentric left ventricular hypertrophy but preserved systolic function. One month later the patient developed severe, acute, symptomatic hypercalcemia with a calcium level of 14.7 mg/dL (corrected to 15.3 mg/dL).