Thoracoscopic removal of ectopic mediastinal parathyroid adenoma

Abstract

Ectopic mediastinal parathyroid adenomas or hyperplasias account for up to 25% of primary hyperparathyroidism cases. Most abnormal parathyroid glands are found in the superior mediastinum within the thymus and can be removed through a cervical incision; however, a few of these glands are not accessible using standard cervical surgical approaches. Surgical resection has traditionally been performed via median sternotomy or thoracotomy. However, recent advancement in video-assisted thoracic surgery techniques has decreased the need for sternotomy or thoracotomy to remove these ectopic parathyroid glands. Here, we report a successful case of video-assisted thoracoscopic removal of a mediastinal parathyroid adenoma.

Keywords: 1. Parathyroid neoplasms; 2. Thoracic surgery, video-assisted; 3. Mediastinum.

Fig. 1

Chest computed tomography shows a 15-mm soft tissue mass at the anterior mediastinum just in front of the ascending aorta.

Fig. 2

(A) A image obtained 15 minutes after intravenous injection of 99mTC-sestamibi show focal uptake in the anterior mediastinum. (B) A delayed image after 3 hours confirms that this area of uptake corresponds to an ectopic parathyroid gland in the anterior mediastinum.