Endocrinol Metab > Volume 22(5); 2007 > Article
Journal of Korean Endocrine Society 2007;22(5):353-358.
DOI: https://doi.org/10.3803/jkes.2007.22.5.353    Published online October 1, 2007.
A Case of Parathyroid Adenoma Manifested as Acute Pancreatitis Accompanied Subclinical Cushing's Syndrome due to an Adrenal Adenoma.
Sang Hoon Leigh, Dong Sik Jo, Si Woo Kim, Yu Jin Jo, Sung Chul Cha, Jung Kwon Kim, Sun Hee Park, Hang Ji Kang
1Department of Internal Medicine, Seoul Adventist Hospital.
2Department of Anatomical Pathology, Seoul Adventist Hospital.
Abstract
The manifestation of primary hyperparathyroidism by acute pancreatitis is a rare event. Furthermore, an asymptomatic adrenal mass may incidentally be detected by abdominal computed tomography. A mass that autonomously secretes glucocorticoid without any symptom is called subclinical Cushing's syndrome. In this study, we report a rare case of a parathyroid adenoma manifested as acute pancreatitis accompanied with subclinical Cushing's syndrome due to an incidental adrenal mass. A 47-year-old female patient presented with acute pancreatitis and hypercalcemia had a parathyroid mass detected by neck ultrasonography and a Tc(99m)-sestamibi scan. An abdominal computed tomography revealed a 3.1 x 4.3 cm mass which was detected in the left adrenal gland. The hormonal levels showed a high serum cortisol level, low ACTH level, and a high 24 h urine free cortisol level. The low and high dose dexamethasone suppression test showed no suppression. The parathyroid and adrenal masses were resected and the laboratory findings were normalized.
Key Words: Acute pancreatitis, Parathyroid adenoma, Subclinical Cushing's syndrome


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