Leukocytosis and hypercalcemia: a rare combination of paraneoplastic features in squamous cell penile cancer.

Penile cancer is very rare in North America and Europe, as compared with the rest of the world. Squamous cell carcinoma (SCC) accounts for more than 95% of the cancer type. Paraneoplastic syndrome (PNS), a clinical syndrome of nonmetastatic systemic effects that occurs in patients with malignant disease, is often associated with SCC. However, the association of penile SCC with leukocytosis and hypercalcemia is very rare. We report a case of penile SCC involving a change in the patient's mental status along with hypercalcemia and leukocytosis; all three conditions resolved after the tumor was excised. We also discuss the possible factors contributing to hypercalcemia, leukocytosis and change in mental status in SCC. These three conditions and other features of PNS can significantly influence a patient's overall prognosis and, if recognized early, can play an important role in the care plan.

Complications related to endoscopic retrograde cholangiopancreatography: a comprehensive clinical review.

Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most commonly performed endoscopic procedures. It provides the treating physician with both diagnostic and therapeutic options. The recent shift towards interventional uses of ERCP is largely due to the emergence of advanced imaging techniques, including magnetic resonance cholangiopancreatography and ultrasonography. With over 500,000 ERCP procedures performed yearly in the United States alone, it is important that all medical and surgical practitioners be well versed in indications, contraindications, potential complications, benefits, and alternatives to ERCP. The authors present an in-depth review of ERCP-related complications (pancreatitis, bleeding, perforation, etc) as well as special topics related to ERCP (periprocedural antibiotic use, performance of intraoperative ERCP, performance of ERCP during pregnancy, etc).