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. |
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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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