A case report of a ectopic parathyroid adenoma and literature review

Abstract Background Giant ectopic mediastinal parathyroid adenoma with cystic degeneration and intratumoral hemorrhage is extremely rare, with low morbidity and a high misdiagnosis rate, and requires precise positioning and surgical resection. Case presentation: A 41-year-old woman presented with a sore throat for 3 days and hoarse voice for 1 day. The following chest computed tomography (CT) showed a large fusiform high-density mass in the posterior tracheal space (maximum cross-section of 34 x 25 mm). ultrasonography of the neck showed a low-echo solid mass. This patient had undergone 2 puncture treatments and 1 surgical treatment from the discovery of the lesion to the diagnosis of the cause over the span of more than a month. Subsequently, the final pathology was definitely diagnosed as parathyroid adenoma with cystic lesions. Six months after the operation, the patient did not relapse. Conclusions This case reported a rare and huge ectopic mediastinal parathyroid adenoma that was misdiagnosed as mediastinal tumor hemorrhage at an early stage. For ectopic mediastinal parathyroid adenomas, surgery is the preferred treatment option. Warn us that we should expand the scope of disease thinking for mediastinal tumors.

Day-case minimally invasive excision of a giant mediastinal parathyroid adenoma

Annals of The Royal College of Surgeons of England ◽

10.1308/003588414x13946184900480 ◽

2014 ◽

Vol 96 (5) ◽

pp. e21-e23 ◽

Cited By ~ 2

Author(s):

A Haldar ◽

A Thapar ◽

S Khan ◽

S Jenkins

Keyword(s):

Minimally Invasive ◽

Parathyroid Adenoma ◽

Neck Exploration ◽

Viable Option ◽

Day Case ◽

Transcervical Approach ◽

Parathyroid Adenomas ◽

Inferior parathyroid adenomas in the mediastinum can be a troublesome cause for hypercalcaemia, requiring a full collar incision or, occasionally, a sternotomy. We report a case of a giant parathyroid adenoma in a 61-year-old woman on warfarin, which we excised via a minimally invasive transcervical approach after radiological localisation. The procedure was performed as a day case and, at six weeks, the patient had recovered fully with biochemical resolution of hypercalcaemia. This case demonstrates that focused transcervical excision of giant parathyroid adenomas is a viable option and should be considered prior to neck exploration or sternotomy.

Excision of an Elusive Tiny Ectopic Parathyroid Adenoma

Case Reports in Oncology ◽

10.1159/000485075 ◽

2017 ◽

Vol 10 (3) ◽

pp. 1105-1111

Author(s):

Andre Navarro ◽

Josanne Vassallo ◽

Joseph Galea

Keyword(s):

Primary Hyperparathyroidism ◽

Parathyroid Adenoma ◽

Gamma Probe ◽

Surrounding Tissue ◽

Uneventful Recovery ◽

Ectopic Parathyroid Adenoma ◽

Ectopic Parathyroid ◽

Upper Mediastinum ◽

An elderly lady was diagnosed with primary hyperparathyroidism after being admitted to hospital with pyelonephritis and constipation. A sestamibi parathyroid scan demonstrated increased uptake in the upper mediastinum, suggesting an ectopic mediastinal parathyroid adenoma. The 4-mm adenoma was successfully removed through a mini-sternotomy incision using a gamma probe to identify the gland from the surrounding tissue. The patient made an uneventful recovery.

Hypercalcemic Crisis Secondary to a Superior Mediastinal Parathyroid Adenoma: A Case Report

Ear Nose & Throat Journal ◽

10.1177/0145561320942021 ◽

2020 ◽

pp. 014556132094202

Author(s):

Ryan David Akin ◽

A. Daniel Pinheiro

Keyword(s):

Parathyroid Adenoma ◽

Definitive Treatment ◽

Transcervical Approach ◽

Hypercalcemic Crisis ◽

Intravenous Hydration ◽

History Of ◽

Ectopic Parathyroid ◽

Diagnostic Capabilities ◽

Hypercalcemic crisis is a rare endocrine emergency that occurs in a small percentage of patients with primary hyperparathyroidism. Although modern diagnostic capabilities allow timely diagnosis and intervention, hypercalcemic crisis still has a high potential for morbidity and mortality. We report an adult patient with a history of kidney stones who presented with heart palpitations, shortness of breath, fatigue, nausea, and 20-pound weight loss over 2 months. Workup revealed hypercalcemia, elevated parathyroid hormone (PTH), and a mediastinal mass on computed tomography angiography. This patient’s hypercalcemic crisis was treated with intravenous hydration using normal saline, zoledronate, and furosemide. After medical optimization, the patient underwent definitive treatment with surgical parathyroidectomy via a transcervical approach. At operation, a large parathyroid adenoma was removed from a posterior–superior mediastinal location dorsal to the recurrent laryngeal nerve with subsequent normalization of calcium and PTH. We discuss the timing of parathyroidectomy in cases of hypercalcemic crisis and the surgical approach to ectopic parathyroid glands in the mediastinum.

Reports of one case of double parathyroid adenomas and one case of ectopic mediastinal parathyroid adenoma

The Chinese-German Journal of Clinical Oncology ◽

10.1007/s10330-010-0049-z ◽

2010 ◽

Vol 9 (5) ◽

pp. 298-301

Author(s):

Xiaoyi Zhang ◽

Lin Zhang ◽

Zhiyong Luo ◽

Lin Sun ◽

Yaqun Wu

Keyword(s):

Parathyroid Adenoma ◽

Parathyroid Adenomas ◽

Robotic thoracoscopic parathyroidectomy for ectopic mediastinal parathyroid adenoma

Grekov s Bulletin of Surgery ◽

10.24884/0042-4625-2021-180-1-89-93 ◽

2021 ◽

Vol 180 (1) ◽

pp. 89-93

Author(s):

P. K. Yablonsky ◽

A. S. Kuzmichev ◽

E. V. Shepichev ◽

A. L. Akinchev ◽

Z. S. Matveeva

Keyword(s):

Parathyroid Adenoma ◽

Single Photon ◽

Photon Emission ◽

Emission Computed Tomography ◽

Persistent Hyperparathyroidism ◽

Ectopic Parathyroid ◽

Photon Emission Computed Tomography ◽

The publication presents the successful experience of using the DaVinci robotic system for the treatment of persistent hyperparathyroidism caused by mediastinal ectopic parathyroid adenoma in 62 years old female patient. The role of single photon emission computed tomography in diagnostics was demonstrated.