Acute Pancreatitis in a Patient With Parathyroid Carcinoma: A Case Report
Bibliographic record
Abstract
Parathyroid carcinoma is a rare endocrine malignancy. Clinical features of parathyroid carcinoma are mainly due to the effects of primary hyperparathyroidism (PHPT). Hypercalcemia produced by primary or secondary hyperparathyroidism is a rare and unclear cause of acute pancreatitis. Acute pancreatitis was rarely described before as the first manifestation of parathyroid carcinoma. The case concerns a 45-year-old man with hypercalcemia (15.9 mg/dL) and high levels of parathyroid hormone (1,089 pg/mL). Laboratory findings and ultrasound directed to right nodular goitre and an adenoma of the right lower parathyroid. The patient underwent right parathyroidectomy and ipsilateral loboistmectomy with laterocervical lymphadenectomy. On the first postoperative day he reported pain in the epigastrium, resistant to analgesics. Laboratory values and computed tomography (CT) scan, associated with clinical data, indicated exudative pancreatitis. It was treated with medical therapy; after some days there was resolution of symptoms and laboratory indexes returned to normal value. Histological examination diagnosed infiltrating parathyroid carcinoma that exceeded its capsule and infiltrated fibroadipose, muscular and perithyroidal tissues. After 18 months, no signs of local recurrence or metastases were observed. Our case report is unusual for its presentation. Acute pancreatitis can be observed in patient with PHPT, but it rarely reveals after parathyroidectomy. In patient who underwent parathyroidectomy with previous hypercalcemia associated with abdominal pain, acute pancreatitis should be suspected. J Endocrinol Metab. 2020;10(2):54-56 doi: https://doi.org/10.14740/jem636
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.004 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.002 | 0.002 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.004 | 0.002 |
| Scholarly communication | 0.003 | 0.003 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".