ABSTRACT
Primary hyperparathyroidism is not uncommon. It has varied presentations ranging from asymptomatic disease to the classic "stones, groans, moans". This is a case report of a 49 year-old woman, who presented with sensory obtundation, abdominal pain, associated with vomiting and denovo detected diabetes mellitus. She had a past history of bilateral nephrolithiasis, and was found to have hypercalcemia [serum corrected calcium 12.8 mg/dL] with elevated serum intact parathormone [183 pg/mL, normal range 13-54 pg/mL]. The 99m-Tc MIBI scintigraphy localized the source of parathormone to the right inferior parathyroid gland. Being dehydrated, she was treated with saline diuresis, salmon calcitonin and intravenous pamidronate. Her blood sugar was reported to be 421 mg/dL, and the glycemia was controlled with insulin therapy. A 2 X 2 cm sized right inferior parathyroid adenoma was later removed. The glycemic status improved dramatically after parathyroidectomy and the patient was euglycemic on low doses of glimepiride. This case study suggests that primary hyperparathyroidism might also contribute to hyperglycemia in subjects with diabetes mellitus
ABSTRACT
Arrhenoblastoma or Sertoli-Leydig cell tumor is a rare androgen secreting ovarian tumor of unknown pathogenesis, has been reported to co-exist with other neoplasms of the female genital tract. Mostly benign, the tumor originates from the ovarian stromal sex cords, its tissue structure being similar to the Sertoli and Leydig testicular cells. Followed in detail, around one-fifth of these ovarian tumors are found to be malignant. We describe a case of slow growing Sertoli-Leydig cell tumor presenting with androgenic alopecia and virilization, associated with cervical carcinoma in-situ