Abstract
A woman in her forties who had been followed for hypercalcemia detected at a medical check-up was referred to our hospital because of increases in serum Ca and intact parathyroid hormone (iPTH) levels. A chest CT scan showed a 2.5-cm tumor shadow at the anterior mediastinum and 99mTc-MIBI parathyroid scintigraphy revealed an increased uptake of RI in the same area as the tumor was situated. Ectopic mediastinal parathyroid adenoma was diagnosed. We performed video-assisted thoracoscopic removal of the mediastinal tumor in a left lateral decubitus with three ports. The operation was initiated following insufflation of CO2 into the thoracic cavity to secure the surgical sight. The tumor was present at the superior margin of the base of the anterior mediastinal ascending aorta. It was the tip of the small finger in size and had been buried in the surrounding thymus. The tumor was removed together with part of the tymus. The histopathological diagnosis was parathyroid adenoma. The postoperative course was uneventful and the elevated serum Ca and iPTH levels rapidly decreased to 8.7mg/dl and 36pg/ml, respectively, on the first postoperative day. There have been no signs of recurrence and she is followed in our clinic.
In this paper, we present a case of an ectopic mediastinal parathyroid adenoma performed video-assisted thoracoscopic removal under CO2 insufflation.
