A case of primary hyperparathyroidism due to a mediastinal parathyroid adenoma accompanied by chronic renal failure

Abstract

Most hyperparathyroidism with chronic renal failure is secondary, and mediastinal parathyroid tumors are relatively rare (approximately 2%). We report a case of primary hyperparathyroidism due to a mediastinal parathyroid adenoma accompanied by chronic renal failure.
A 42-year-old man had been undergoing dialysis therapy, was admitted to our hospital with high serum Ca, P and intact-PTH. Chest CT and MRI showed a mass measuring 3 cm in diameter in the anterior mediastinum, and ^99mTc-MIBI scintigram demonstrated abnormal radioactivity accumulation in the anterior mediastinum. CT and ultrasonography of the neck revealed no abnormal findings. From the results of the above examinations, hypercalcemia resulted from primary hyperparathyroidism due to a mediastinal parathyroid adenoma. The mediastinal tumor was resected in thoracoscopic surgery. Histologically, it was diagnosed as a parathyroid adenoma.
In hypercalcemia with renal failure, it is important to check for primary hyperparathyroidism.