Two exceptional etiologies of classic endocrinopathies
Brakni Lila, Chenak Lies, Iabassen Malek & Kemali Zahra
Introduction: Two patients admitted for evaluation of a hypercalcemia and hypothyroidism whose etiologic diagnosis showed itself unusual.
Case no. 1: A 45 years old man allowed for disorders of consciousness, vomitings and headaches, biology showed a hypercalcemia, a hypophosphoraemia, hyperPTH. The imaging revealed parathyroidal adenoma with a compressive prolactinema. Pet Scan-FDG showed a metabolic activity of the thymic cavity with a necrotic aspect, five pancreatic nodules and adrenal nodules without pheochromocytoma.
He has benefited from the resection of a parathyroidal adenoma from thymoma of P3 type invasive and hypophyseal adenomectomy. Search of MEN1 was positive.
Case no. 2: A 58 years old Mrs admitted for hypothyroidism post-radiation of a thymic carcinoma diagnosed 3 years earlier. Biology showed a hypercalcemia, a hypo phosphoraemia, hyperPTH in touch with parathyroidal adenoma. Imaging showed adrenal mass. Immunohistology ended has a pheochromocytoma. Besides, she presents a gastritis. The search of one MEN1 was negative.
Conclusion: These cases illustrate the interest of a fine analysis of the usual clinical and biological data as well as the contribution of the current techniques of biology and imaging for the etiologic and topographic.