<prompt> Patients may experience fatigue, mental status changes, dehydration, or symptoms of nephrolithiasis in humoral hypercalcemia of malignancy , is when the serum calcium level is more than:14 mgdl12 mgdl11 mgdl10 mgdl  <response>: Humoral hypercalcemia of malignancy HHM Humoral hypercalcemia of malignancy HHM occurs in 20 of cancer. It is commonly seen in cancers of the lung, head and neck, esophagus, breast, genitourinary tract and in multiple myeloma lymphomas. Caused most commonly by overproduction of PTHrP When the calcium levels are markedly increased 14 mgdL patients may experience fatigue, mental status changes, dehydration, symptoms of nephrolithiasis. Ref: Harrison,E-18,P-828 