MEN1 Syndrome with an Unusual Pancreatic Presentation of Chronic Pancreatitis with Pancreatic Duct Stone: A Case Report
Journal of Practical Emergency Medicine,
Vol. 13 No. 1 (2026),
1 January 2026
,
Page e24
https://doi.org/10.22037/jpem.v13i1.48765
Abstract
Multiple Endocrine Neoplasia type 1 (MEN1) is a rare autosomal dominant endocrine tumor syndrome characterized mainly by tumors involving the parathyroid glands, pancreatic/duodenal neuroendocrine system, and anterior pituitary gland. Primary hyperparathyroidism is the most frequent manifestation of MEN1. Although pancreatic neuroendocrine tumors are well recognized in MEN1, other pancreatic abnormalities, including chronic pancreatitis, are less clearly established and require careful interpretation. We report a case of a 35-year-old Middle Eastern female presenting with recurrent upper abdominal pain and previous episodes of acute pancreatitis. Laboratory evaluation demonstrated hypercalcemia with markedly elevated parathyroid hormone (PTH) levels, consistent with primary hyperparathyroidism. Imaging revealed a left parathyroid lesion, chronic pancreatitis with pancreatic duct dilatation and intraductal stone, and a small pituitary microadenoma without clinical evidence of hormone hypersecretion. Based on the coexistence of primary hyperparathyroidism and pituitary adenoma, a clinical diagnosis of MEN1 was considered. Genetic testing for MEN1 mutation was not performed due to financial limitations. The patient underwent parathyroidectomy, with normalization of calcium and PTH levels and improvement of abdominal symptoms. The pancreatic duct stone was managed conservatively, and the pituitary lesion remained under surveillance. This case describes a patient with a clinical MEN1 phenotype and an unusual coexistence of chronic pancreatitis with pancreatic duct stone. Although the pancreatic finding cannot be confirmed as a MEN1-associated manifestation, its presence highlights the importance of considering endocrine disorders in patients with recurrent pancreatitis and multiple endocrine abnormalities. Further evaluation and long-term surveillance are required in patients with suspected MEN1.
- Chronic Pancreatitis
- Hyperparathyroidism
- Microadenoma
How to Cite
References
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