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Review
. 2016 Jan;5(1):70-3.
doi: 10.3978/j.issn.2225-319X.2015.08.12.

Mediastinal giant parathyroid adenoma-a minimally invasive mediastinal surgical approach for an emergency presentation

Mira Pecheva  1 , Kajan Mahendran  1 , Jakub Kadlec  1 , Matthew Lofthouse  1 , Filip Van Tornout  1
Affiliations
Review

Mediastinal giant parathyroid adenoma-a minimally invasive mediastinal surgical approach for an emergency presentation

Mira Pecheva et al. Ann Cardiothorac Surg. 2016 Jan.
No abstract available

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Video 1
Video 1
Mediastinal giant parathyroid adenoma—a minimally invasive mediastinal surgical approach for an emergency presentation. Available online: http://www.annalscts.com/article/view/8481/9668
Figure 1
Figure 1
(A) Computed tomography (CT) scan of the thorax showing a complex cystic solid mass in the middle/superior mediastinum. CT revealed a complex cystic solid mass in the middle/superior mediastinum with peripheral calcification, a solid enhancing component, internal septation and fluid density, seen at the right lateral aspect of the trachea and the esophagus and closely related to the right subclavian artery. These findings were not typical of ectopic parathyroid tissue. There was no significant neck, hilar, axillary or mediastinal lymphadenopathy; (B) CT guided biopsy. A CT guided biopsy was performed following multidisciplinary discussion. It confirmed a 47 mm × 38 mm low attenuation lesion.
Figure 2
Figure 2
Post-biopsy CT showing a large right sided hemothorax. A large right sided hemothorax is seen to occupy most of the pleural cavity. The mediastinal tumor is seen to the right of the trachea, with evidence of tracheal deviation and mediastinal shift.
Figure 3
Figure 3
Macroscopic view of the parathyroid adenoma. The mass was a 19-g mediastinal giant parathyroid adenoma on histology, measuring 39 mm × 37 mm × 19 mm. Macroscopically, tan mucosa was seen on the surface, with a hemorrhage filled cavity and a fibrous wall up to 2 mm thick with focal calcifications.
Figure 4
Figure 4
There was microscopic evidence of composite tissue arranged in sheets, trabeculae and acini formed of cells with round to ovoid nuclei, inconspicuous nucleoli and moderate amounts of clear and eosinophilic cytoplasm, consistent with a parathyroid adenoma. There was no evidence of malignancy. Immunohistochemistry showed diffuse strong staining for MNF116, and PAX8, and was negative for TF1 and thyroglobulin immunostains. (A) Microscopic view of the parathyroid adenoma—low power (magnified ×4); (B) microscopic view of the Parathyroid adenoma—high power (magnified ×20).
Figure 5
Figure 5
Post-operative chest X-ray at 6 weeks. The right lung is fully expanded and the paratracheal mass has been fully excised.
See this image and copyright information in PMC

References

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