Mediastinal parathyroid carcinoma: a case report and review of the literature

Abstract

Background Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal PC and conduct a related literature review. Case presentation We described a case of a 50-year-old female patient with PHPT due to mediastinal PC. She was initially admitted to a local hospital in her hometown with hypercalcemia and high blood concentrations of PTH (parathyroid hormone). The patient underwent neck parathyroidectomy and pathological examination suggested parathyroid adenoma. Although the overproduction of serum calcium and PTH declined after the surgery, calcium and PTH increased again one month later, so the patient was transferred to our hospital. A 99mTc-sestamibi scan revealed an ectopic finding in the mediastinum, which was also indicated on the CT image. After removing the mediastinal mass, the metabolism of calcium and PTH quickly reverted to normal and the pathologic features of the mass were consistent with PC. By reviewing the related literature, we noticed that only scattered reports were published before 1982, and those were not included in the present review due to their differences with current radiological examination and treatment methods. After excluding outdated studies, we summarized and analyzed 20 reports of isolated mediastinal PC and concluded that. Parathyroidectomy remains the only curative treatment for the disease. Furthermore, the success of treatment directly depends on accurate preoperative localization. Conclusion With this study, we emphasize the importance of accurate preoperative diagnosis of mediastinal PC and improve clinicians’ understanding of the disease.

A case report of mediastinal parathyroid carcinoma in a chronic kidney disease patient: Addressing management conundrum

“…In fact, the ectopic glandular tissue may go undetected, during initial presentation leading to the unnecessary removal of the cervical parathyroid glands. 22 Individuals with prior parathyroid tumors should undergo routine surveillance follow up after initial management. In those with clinical findings suggestive of hyperparathyroidism in the absence of parathyroid mass on physical and radiological examination, ectopic parathyroid cancer must be considered, and appropriate localization imaging studies pursued.…”