title: Acute pancreatitis caused by an ectopic mediastinal parathyroid adenoma.
abstract: A 22-year-old man was admitted to our hospital because of epigastric pain. Blood tests showed leukocytosis (8940 cells/mm(3)) and increased serum amylase levels (787 IU/L); an abdominal computed tomography (CT) scan revealed an enlarged pancreas and peripancreatic fluid collection. On the basis of these findings, he was diagnosed with acute pancreatitis. Hypercalcemia (13.5 mg/dL) and increased levels of parathormone (>3200 pg/dL) were also detected using a high-sensitivity assay; we therefore considered hypercalcemia and primary hyperparathyroidism to be the possible causes of the acute pancreatitis. A (99m)Tc-sestamibi scan showed accumulation of parathyroid tissue in the left mediastinum, and a tumor was noted on the left side of the aortic arch on a thoracic CT scan. Our final diagnosis was acute pancreatitis due to hypercalcemia induced by an ectopic mediastinal parathyroid adenoma. Ectopic parathyroid tumors can thus cause acute pancreatitis, and (99m)Tc-sestamibi and CT scans are useful for their diagnosis and localization.
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan. tagatame0126@yahoo.co.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Urata
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Yamasaki
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sasaki
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Ginga
authors.initials: G
authors.lastname: Tonaki
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Iwasaki
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Minami
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Rituko
authors.initials: R
authors.lastname: Yoshioka
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Kitada
authors.affiliation: Department of Gastroenterology, Japanese Red Cross Kumamoto Hospital, 2-1-1, Nagamine Minami, Kumamoto, 861-8520, Japan.
authors.forename: Yoshi
authors.initials: Y
authors.lastname: Takekuma
keywords: 99mTc-sestamibi scan; Acute pancreatitis; Ectopic mediastinal parathyroid adenoma; Hypercalcemia; Primary hyperparathyroidism