Management of mediastinal parathyroid adenoma via minimally invasive thoracoscopic surgery: Case report

Abstract

HighlightsEctopic parathyroid adenomas are rare.PA’s can cause idiopathic hypercalcemia.VATS in the recommended treatment of choice.

WITHDRAWN: An anatomic aberration and a surgical challenge: Mediastinal parathyroid adenoma anterior the pericardium. A case report

“…According to previous studies and case reports, ultrasonography did not aid in detecting mediastinal adenomas, as demonstrated in the presented case as well [7,14,15]. In addition, CT and MRI seem to contribute to identifying these adenomas and they tend to provide valuable information as for their anatomical correlation to nearby tissues [7,8,14,15]. Other studies show that a combination of CT and PET-CT could facilitate even more the localization of these adenomas [7,15].…”

“…However, there is some controversy when it comes to choosing the optimal preoperative imaging techniques [3,12,15]. According to previous studies and case reports, ultrasonography did not aid in detecting mediastinal adenomas, as demonstrated in the presented case as well [7,14,15]. In addition, CT and MRI seem to contribute to identifying these adenomas and they tend to provide valuable information as for their anatomical correlation to nearby tissues [7,8,14,15].…”

“…Primary hyperparathyroidism (PHPT) affects approximately 25 per 100,000 in the general population and it is more prevalent among older people, aged 50-years old or more, as in the presented case [6,7]. The diagnosis of PHPT may be established when the patient presents hypercalcemia, hypophosphatemia and raised levels of alkaline phosphatase and iPTH and typical clinical manifestations, such as recurrent presence of kidney stones, hypertension, peptic ulcers and osteopenia [6,8,9].…”

“…Embryologically, the parathyroid glands are derived from the third and fourth pharyngeal pouches and descend along with the thyroid gland. In case of failure of the present process, the parathyroid glands may be detected in the neck posterior to the mandible or within the mediastinum as ectopic tissues [7,8].…”

“…Nevertheless, the main concern of physicians in these rare cases is to spare patients suffering from PHPT from unnecessary interventions. For this reason, preoperative imaging interventions are essential before any exploration for parathyroid adenomas – in our case deep into the anterior mediastinum [7,13,14].…”