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Abstract  Cirrhotic patients with hepatocellular carcinoma (HCC) frequently develop hepatic encephalopathy. Metabolic etiology of encephalopathy is less often considered in these patients. Although paraneoplastic hypercalcemia may be associated with several malignant tumors, it has also been described in HCC [1–4], and may cause neurologic disturbances. We present a case of hypercalcemic encephalopathy in a patient with hepatic cirrhosis and underlying HCC in whom first diagnostic was hepatic encephalopathy. [ABSTRACT FROM AUTHOR]