Supernumerary Ectopic Mediastinal Parathyroid Adenoma Combined With Parathyroid Hyperplasia

Abstract

Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by elevatedparathyroid hormone levels. In most cases, the disease involves a single parathyroid adenoma,followed by parathyroid hyperplasia, but the incidence of ectopic parathyroid adenomais rare. However, in cases where the parathyroid hormone level remains high even after parathyroidsurgery, an ectopic parathyroid gland should be considered. Here in a case of a 60-yearoldfemale who presented PHPT is reported. She had undergone a surgical removal of theparathyroid gland of suspected hyperplasia, but still represented persistent PHPT, postoperatively. Ectopic mediastinal parathyroid adenoma was identified by 99mTc-sestamibi parathyroidscan and surgical excision via a median sternotomy approach was performed. Thirtyeightmonths postoperatively, there was no evidence of recurrence. Preoperative localizationassessment is critical for minimizing surgical failure in cases of PHPT.