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고칼슐혈증으로 인한 급성 췌장염은 매우 드문 경우이지만 우리나라에서도 보고된 바 있으나 부갑상선종과 무증상 부신 선종이 동반된 경우는 국내에는 없으며 세계적으로도 Makino 등[19], Sawano 등[20]이 보고한 사례만 있을 정도로 매우 드문 질환이다.


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 Tc99m-sestamibi scan. An abdominal computed tomography revealed a 3.1 × 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. (J Kor Endocrine Soc 22:353~358, 2007)