Chen C S, Tseng F Y
Department of Internal Medicine, Taipei Provincial Hospital, Taiwan R.O.C.
J Formos Med Assoc. 1991 Dec;90(12):1200-4.
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.
1957年，科普及其同事首次注意到2例与原发性甲状旁腺功能亢进相关的胰腺炎病例。他们强调了甲状旁腺功能亢进与胰腺炎之间的关联。从那时起，胰腺炎已成为原发性甲状旁腺功能亢进的一个诊断线索。我们在此报告一名39岁女性，她在过去2年中曾3次患急性复发性胰腺炎。高钙血症在整个病程中持续存在。体格检查发现右甲状腺区域有一个直径3×3厘米的可移动肿块。在甲状腺右叶与颈动脉之间发现一个低回声肿块，大小为3.5×2.7×1.4厘米。由于血清钙水平持续升高，输注了生理盐水和呋塞米；血清钙逐渐下降。对疑似肿块进行穿刺抽吸后，血清钙水平从8.7毫克/分升升至18毫克/分升。由于怀疑是甲状旁腺腺瘤，遂进行手术，顺利切除一个3×2.5×1.5厘米、包膜完整的肿块。病理检查显示为包膜完整的甲状旁腺腺瘤。该病例表明，原发性甲状旁腺功能亢进可能是胰腺炎的病因之一，细针穿刺抽吸活检细胞学检查虽然可能有助于诊断，但可加重高钙血症。
