American Journal of Medical Sciences and Medicine
ISSN (Print): 2327-6681 ISSN (Online): 2327-6657 Website: http://www.sciepub.com/journal/ajmsm Editor-in-chief: Apply for this position
Open Access
Journal Browser
Go
American Journal of Medical Sciences and Medicine. 2022, 10(2), 40-43
DOI: 10.12691/ajmsm-10-2-1
Open AccessCase Report

Acute Pancreatitis in an Atypical Parathyroid Adenoma: A Rare Case of Hyperparathyroidism

Luis M. Nieto1, , Sharon Narvaez2, Sinetsehay Temesgen1, Pooja Singh1 and Israel Orija1

1Department of Internal Medicine, WellStar Atlanta Medical Center, Atlanta, Georgia, USA

2Facultad de Ciencias Medicas, Universidad de Guayaquil, Ecuador

Pub. Date: May 18, 2022

Cite this paper:
Luis M. Nieto, Sharon Narvaez, Sinetsehay Temesgen, Pooja Singh and Israel Orija. Acute Pancreatitis in an Atypical Parathyroid Adenoma: A Rare Case of Hyperparathyroidism. American Journal of Medical Sciences and Medicine. 2022; 10(2):40-43. doi: 10.12691/ajmsm-10-2-1

Abstract

Primary hyperparathyroidism is a common manifestation of parathyroid disease. Atypical parathyroid adenoma and parathyroid carcinoma are rare causes of primary hyperparathyroidism and pathologic differentiation is challenging. A 44-year-old Caucasian female presented with abdominal pain, nausea, and vomiting. Her serum calcium, intact PTH, and lipase levels were elevated at presentation. Radiological assessment revealed a parathyroid mass. After parathyroidectomy, pathology demonstrated an atypical parathyroid adenoma. We present a case of primary hyperparathyroidism due to an atypical parathyroid adenoma associated with acute pancreatitis. Concurrence of severe hypercalcemia in the setting of atypical parathyroid adenoma and acute pancreatitis is very uncommon, with a small number of reported cases.

Keywords:
primary hyperparathyroidism atypical parathyroid adenoma acute pancreatitis

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References:

[1]  Khoo, T. K., Vege, S. S., Abu-Lebdeh, H. S., Ryu, E., Nadeem, S., & Wermers, R. A. (2009). Acute pancreatitis in primary hyperparathyroidism: a population-based study. The Journal of Clinical Endocrinology & Metabolism, 94(6), 2115-2118.
 
[2]  Galani, A., Morandi, R., Dimko, M. et al. Atypical parathyroid adenoma: clinical and anatomical pathologic features. World J Surg Onc 19, 19 (2021).
 
[3]  SCULLY,R et al Case 32-1996. A 44-Year-Old Woman with a Long History of Intermittent Hypercalcemia, a New Neck Mass, and Hypercalcemic Crisis, N Engl J Med 1996; 335:1213-1220.
 
[4]  Pearlstein, S. S., Eric, K., Kate, C. H., Khanafshar, E., & Duh, Q. Y. (2021). Clinical Behaviors of Atypical Parathyroid Adenomas. Journal of the Endocrine Society, 5(Suppl 1), A258-A259.
 
[5]  Carlson D. Parathyroid pathology: Hyperparathyroidism and parathyroid tumors. Arch Pathol Lab Med 2010; 134: 1639-44.
 
[6]  Thompson LD. Benign and malignant neoplasms of the parathyroid glands. In: Goldblum JR, editor. Endocrine Pathology. 2nd ed. London: Churchill Livingstone; 2006. p. 157-81.
 
[7]  Fernandez-Ranvier, G.G., Khanafshar, E., Jensen, K., Zarnegar, R., Lee, J., Kebebew, E., Duh, Q.-Y. and Clark, O.H. (2007), Parathyroid carcinoma, atypical parathyroid adenoma, or parathyromatosis?. Cancer, 110: 255-264.
 
[8]  SCULLY,R et al Case 32-1996 — A 44-Year-Old Woman with a Long History of Intermittent Hypercalcemia, a New Neck Mass, and Hypercalcemic Crisis, N Engl J Med 1996; 335: 1213-1220.
 
[9]  G Ippolito, F F Palazzo, F Sebag, C De Micco, J F Henry, Intraoperative diagnosis and treatment of parathyroid cancer and atypical parathyroid adenoma, British Journal of Surgery, Volume 94, Issue 5, May 2007, Pages 566-570.
 
[10]  Cetani, F., Marcocci, C., Torregrossa, L., & Pardi, E. (2019). Atypical parathyroid adenomas: challenging lesions in the differential diagnosis of endocrine tumors, Endocrine-Related Cancer, 26(7), R441-R464. Retrieved Feb 9, 2022, from https://erc.bioscientifica.com/view/journals/erc/26/7/ERC-19-0135.xml.
 
[11]  Erdheim J (1903) Zur Normalen und Pathologischen Histologie der Glandule Thyroidea, Parathyroidea und Hypopyisis. Beitrage zur pathologischen Anatomie und zur allgemeinen. Pathologie 33: 158.
 
[12]  Egea Valenzuela J, Belchi Segura E, Sanchez Torres A, et al.: Acute pancreatitis associated with hypercalcemia. a report of two cases. Rev Esp Enferm Dig. 2009, 101:65-9.
 
[13]  Bess MA, Edis AJ, van Heerden JA. Hyperparathyroidism and pancreatitis. Chance or a causal association? JAMA. 1980 Jan 18; 243(3): 246-7. PMID: 7350371.
 
[14]  Sherin Hashem, MD PhD, Grace Lin, MD PhD, Vera Vavinskaya, MD, Oluwole Fadare, MD, SAT-352 Severe Primary Hyperparathyroidism, Hypercalcemic Crisis, Acute Pancreatitis and Fatality: Complications of Atypical Parathyroid Adenoma, a Case Report, Journal of the Endocrine Society, Volume 4, Issue Supplement_1, April-May 2020, SAT-352.
 
[15]  Lee, J., Lin, E., Hashem, S., Fadare, O., & Sell, R. E. (2020). Acute Pancreatitis as a Manifestation of Primary Hyperparathyroidism. In C43. CRITICAL CARE CASE REPORTS: THE GASTROINTESTINAL TRACT, LIVER, AND PANCREAS (pp. A5145-A5145). American Thoracic Society.