A Case of a Retroesophageal Parathyroid Adenoma with an Aberrant Right Subclavian Artery: A Potential Surgical Pitfall

Abstract

We report a case of retroesophageal parathyroid adenoma coexisting with an aberrant right subclavian artery (ARSA). A 63-year-old female presented with elevated serum calcium and intact parathyroid hormone levels. 99m Tc-methoxyisobutylisonitrile scintigram and enhanced chest computed tomography (CT) revealed a mediastinal tumor measuring 25 × 15 × 7 mm located posterior to the esophagus. Three-dimensional CT provided accurate anatomical location of the tumor and the ARSA. We safely resected the ectopic parathyroid adenoma using video-assisted thoracic surgery owing to the accurate location of the adenoma and its relationship to the surrounding anatomical structures including the ARSA.

Use of Vascular Clues to Locate Ectopic Parathyroid Glands and Predict Anatomic Abnormalities

“…Here we have reported a case of ectopic retroesophageal left superior parathyroid adenoma associated with an aberrant right subclavian artery. To our knowledge, this finding has been described in only 1 prior case …”

Primary hyperparathyroidism

“…Nevertheless, the general anaesthesia must be used, and the operating time is longer. Moreover, this method may be successfully used in complicated cases, such as retroesophageal parathyroid adenoma coexisting with an aberrant right subclavian artery [47]. During endoscopic parathyroidectomy the patient needs to be placed in a supine position.…”