Thoracoscopic surgical case of an ectopic mediastinal parathyroid adenoma detected by chance: a case report

• Main Authors: Shota Mitsuboshi, Hideyuki Maeda, Hiroe Aoshima, Tamami Isaka, Takako Matsumoto, Hiromi Onizuka, Masato Kanzaki
• Format: Article
• Language: English
• Published: BMC 2019-11-01
• Series: BMC Surgery
• Subjects: Video-assisted thoracoscopic surgery; Ectopic mediastinal parathyroid tumor; Technetium-99 m methoxyisobutyl isonitrile scintigraphy
• Online Access: http://link.springer.com/article/10.1186/s12893-019-0641-2

Abstract Background Ectopic mediastinal parathyroid tumor (EMPT) is a rare cause of primary hyperparathyroidism (PHPT); it is difficult to resect using the cervical approach. We describe a case of using video-assisted thoracic surgery (VATS) for EMPT resection. Case presentation A 67-year-old woman with a history of postoperative thyroid cancer had no symptoms. She was diagnosed with PHPT and underwent thyroid cancer surgery. She had serum calcium and intact parathyroid hormone (PTH) levels of 11.1 mg/dL and 206 pg/mL, respectively. Chest computed tomography showed a 10-mm nodule in the anterior mediastinum. Technetium-99 m methoxyisobutyl isonitrile scintigraphy showed an abnormal uptake lesion in the anterior mediastinum. She was diagnosed with PHPT caused by EMPT and underwent VATS. The pathological examination confirmed parathyroid adenoma. Her serum calcium and intact PTH levels were normal from 15 min after tumor resection. She has had no recurrence of EMPT. Conclusions The VATS approach was effective for the resection of EMPT.