Pancreatic islet-cell neoplasia, with secretion of a parathormone-like substance and hypercalcemia

In a 47-year-old woman with a pancreatic mass associated with hypercalcemia and mental confusion, medical measures failed to restore her serum calcium level to normal. To do so, radical resection of a locally invasive vascular neoplasm arising from the body and tail of the pancreas was necessary. The neoplasm was a pancreatic islet-cell tumour. Serum parathormone assays demonstrated abnormally high secretion of a parathormone-like substance. Ectopic secretion of such substances from islet-cell tumours should be considered in association with refractory metabolic disturbances. In view of the often indolent clinical course of islet-cell tumours and the potential for life-threatening hormonal effects, biopsy confirmation of adenocarcinoma should be obtained before resorting to palliative surgical management of pancreatic neoplasms.