Video Assisted Thoracoscopic Surgery (VATS) for Excision of an Ectopic Anterior Mediastinal Intra-Thymic Parathyroid Adenoma
Published: June 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/.8023
Dukhabandhu Naik, Kumaradoss Felix Jebasingh, Ramprasath, Gnanamuthu Birla Roy, Mazhuvanchary Jacob Paul
1. Associate Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.
2. Senior Registrar, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, India.
3. Assistant Professor, Department of Thoracic surgery, Christian Medical College, Vellore, India.
4. Professor, Department of Thoracic Surgery, Christian Medical College, Vellore, India.
5. Professor and Head, Department of Endocrine Surgery, Christian Medical College, Vellore, India.
Correspondence
Dr. Mazhuvanchary Jacob Paul,
Professor and Head, Department of Endocrinology Surgery,
Christian Medical College Hospital, Vellore-632004, India.
E-mail: mjpaul@cmcvellore.ac.in
Ectopic anterior mediastinal parathyroid adenoma is a rare cause of Primary Hyperparathyroidism (PHPT). Imaging studies such as Technetium-99m (99mTc) sestamibi parathyroid scan along with a Single Photon Emission Computerized Tomogram (SPECT), and contrast enhanced Computerized Tomogram (CT) of the neck and thorax can precisely localize the ectopic mediastinal parathyroid adenoma. We report a 40-year-old gentleman who presented with persistent pain in the right shoulder following trivial trauma. His biochemical investigations showed an elevated serum calcium of 11.6mg% (Normal: 8.3-10.4 mg%) along with an elevated iPTH of 1443 pg/ml (normal: 8-70 pg/ml) which were suggestive of primary hyperparathyroidism. The localization studies revealed an ectopic cystic parathyroid adenoma in the anterior mediastinum that was not accessible from the neck. He underwent a Video Assisted Thoracoscopic (VAT) excision procedure with normalization of serum calcium and an uncomplicated recovery. The VAT approach is a successful minimally invasive technique for mediastinal parathyroidectomy.
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