20th August 2020

A 36-year-old woman is seen in the general endocrine clinic

A 36-year-old woman is seen in the general endocrine clinic. The consultant asks you about the rather odd constellation of symptoms that she has experienced – she initially presented following infrequent episodes of throbbing headaches, racing heartbeat and anxiety. Clinically she was found to be hypertensive during these episodes and plasma and urinanalysis showed raised metanephrines. After a few months she also started experiencing tingling in her fingertips and toes and was subsequently found to have raised levels of parathyroid hormone. She also had a recent biopsy taken from the neck following an ultrasound scan after a clinically palpable lump was felt in the midline of her neck. 

For the patient above, please select the SINGLE most likely cause for her symptoms. Select ONE option from the list above.