Acute relapsing pancreatitis in primary hyperparathyroidism with hypercalcemia aggravated after aspiration cytology: report of a case.
In 1957, Cope and his associates first noted 2 cases of pancreatitis associated with primary hyperparathyroidism. They emphasized the association of hyperparathyroidism and pancreatitis. Since then pancreatitis has become a diagnostic clue to primary hyperparathyroidism. We report herein a 39-year-old woman who had suffered from acute relapsing pancreatitis 3 times in the past 2 years. Hypercalcemia persisted throughout the course. A movable mass 3 x 3 cm in diameter was noted over the right thyroid area on physical examination. A hypoechogenic mass 3.5 x 2.7 x 1.4 cm was found between the right lobe of the thyroid and the carotid artery. Because of a persistently high serum level of Ca2+, normal saline and furosemide were infused; the serum Ca2+ decreased gradually. After aspiration of the suspected mass, the serum level of Ca2+ increased from 8.7 mg/dL to 18 mg/dL. Because of the impression of parathyroid adenoma, surgery was performed and a 3 x 2.5 x 1.5 cm well-encapsulated mass was excised without difficulty. Pathologic examination revealed a well-encapsulated parathyroid adenoma. This case reveals that primary hyperparathyroidism maybe one of the causes of pancreatitis, and aspiration cytology, although it may be helpful for the diagnosis, can aggravate the hypercalcemia.
Chen
C S
CS
Department of Internal Medicine, Taipei Provincial Hospital, Taiwan R.O.C.
Tseng
F Y
FY
D000208:Acute Disease; D000236:Adenoma / Q000150:complications / Q000473:pathology; D000328:Adult; D001707:Biopsy, Needle / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D006961:Hyperparathyroidism / Q000150:complications* / Q000473:pathology; D010195:Pancreatitis / Q000209:etiology*; D010282:Parathyroid Neoplasms / Q000150:complications / Q000473:pathology; D012008:Recurrence