Primary hyperparathyroidism masquerading as acute pancreatitis: A case of parathyroid adenoma

Abstract This case discusses an atypical presentation of parathyroid adenoma and its management. Primary hyperparathyroidism (PHPT) is defined by elevated calcium levels and increased parathyroid hormone (PTH). In 85% of PHPT cases, a parathyroid adenoma is the underlying cause. A 49-year-old man presented with acute abdominal pain and was diagnosed with acute pancreatitis. Routine tests showed hypercalcemia (serum calcium >14 mg/dL) and an elevated PTH level (601.8 pg/mL). Initial ultrasound imaging of the neck showed that parathyroid glands were not visualized, and it was not correlating clinically. This was followed by a Tc99 sestamibi parathyroid scan which showed hyperfunctioning parathyroid tissue posterior to the upper lobe of the thyroid gland suggestive of left upper parathyroid adenoma. Pancreatitis is an uncommon manifestation of parathyroid adenoma, but it should be considered in the differential diagnosis when treating patients. Individuals with recurrent, unexplained pancreatitis should be evaluated for a potential parathyroid adenoma.