The specimen consists of much of the body of the pancreas; at the tail there is a circumscribed
tumour approximately 1.5 cm in maximum diameter. The cut surface looks rather fibrous and pale.
This woman first presented at the age of 22 with a two-year history of urinary tract
infections; renal calculi were demonstrated and the serum calcium was elevated. One parathyroid
adenoma and 3 normal parathyroid glands were removed. Three years later she presented with
hypoglycaemia; the cause could not be demonstrated until 2 years later when the present lesion
was resected and a second adenoma of similar size was enucleated from the upper surface of the
pancreas. Two years later there was evidence of recurrent hyperparathyroidism and her neck was
again explored and 1 parathyroid adenoma and 4 probable adenomas were removed. (Multiple
endocrine adenomas - Type I).