Mediastinal parathyroid adenomas and their surgical implications

Abstract

Primary hyperparathyroidism is a relatively common problem encountered by any endocrine surgical unit. Ectopic parathyroid adenomas have been known to be a common cause of persistent hyperparathyroidism after surgery. A common site of the missed ectopic gland will be that in the mediastinum. However, with the increasing improvement in available imaging, it is likely that this can be diagnosed preoperatively. The surgical approach to the mediastinal parathyroid has also changed vastly over the last decade from maximally invasive to minimally invasive with minimal complications. We provide a review on the entity of mediastinal parathyroid adenomas and their surgical implications.

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

“…These surgical interventions are associated with a risk of injury to phrenic and recurrent laryngeal nerve, laceration of brachiocephalic vein, delayed wound healing, wound infection, mediastinitis and even death. The size of surgical incisions is often large and aesthetically unsound for the patient [12] .…”

Giant mediastinal parathyroid adenoma presenting as bilateral brown tumour of mandible: a rare presentation of primary hyperparathyroidism

“…Among the autopsied specimens, ectopia is seen in up to 42% of cases 17. The inferior ones are more prone to migrate in close relation with thymus 12.…”

Videothoracoscopic resection of a posterior mediastinal parathyroid adenoma in a patient with aberrant subclavian artery

“…False positivity may be detected in patients with lung cancer metastasis or patients with mediastinal tumors such as thymoma, seminoma, and lymphoma. False negativity may be seen in patients with multiple adenomas or hyperplasia [6]. Also, thoracic computed tomography (CT) and magnetic resonance imaging are helpful to determine the anatomic localization and the relationship of mediastinal parathyroid adenoma with the other structures.…”