Evidence of acute pancreatitis in a patient with radioresistant-differentiated thyroid cancer.

Peroxisome proliferator-activated receptor (PPAR) agonists are sometimes used in patients with radioiodine-resistant differentiated thyroid cancers in order to effect further differentiation of the tumor and increase the chance of therapeutic success with subsequent doses of radioiodine. PPAR agonists are reportedly protective of the pancreas and have been proposed as agents that might be useful in the prevention of pancreatitis. In this report, we describe a patient treated with the PPAR agonist rosiglitazone for thyroid cancer who showed imaging abnormalities on PET scan and biochemical evidence of acute pancreatitis. Despite evidence of acute pancreatitis, the etiology of which is unclear, the patient remained asymptomatic. It is speculated that the lack of symptoms in this patient was due to the suppression by rosiglitazone of proinflammatory cytokines.