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Mediastinal paratyhyroid adenoma and hyperparathyrodism

Fuentes-Valdés, Edelberto1; Pérez-García, Kymani2; Fuentes-Valdés, Ronald Néstor3





2020, Number 4

2020; 79 (4)






ABSTRACT

Mediastinal ectopic parathyroid glands accounted for 6 to 16% of the patients with hyperparathyroidism. Objective: To present two cases of hyperfunctioning parathyroid glands located in the anterior and superior mediastinum (1) and in the posterior and superior mediastinum (1). Gammagraphic study (99mTc-methoxyisobutylisonitrile [99mTc-MIBI]) demostrated the presence of ectopic glands and defined their location. Case presentation: The first patient (masculine) the intervention began through a cervical mediastinoscopy, but fibrosis caused by a previous surgical operation obliged to convert to a partial sternotomy (manubrium). Removed adenoma was in contact with thymus. Forty eight months after operation then patient was asymptomatic Forth eight months later, the patient was asymptomatic, with normal physical and intellectual activity. The second patient (female) had an upper and anterior mediastinal parathyroid adenoma. The tumor was removed through a videoassisted thoracic surgery (3 ports), with orotracheal anesthesia and the right lung collapsed. The patient had an uneventful postoperative recovery. Eighteen months later she enjoyed a normal life with normal PTH levels. Conclusions: Mediastinal ectipic parathyroid glands are rare. They can present in the anterior mediastinum, associated to the thymus on in the posterior mediastinum, preferable in the tracheoesophageal groove. To the best of our knowledge, the second patient was the first treated by videoassisted thoracoscopic surgery in our country.

KEYWORDS

Parathyroid glands, adenoma, huperparathyroidism, mediastinum, surgery.

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2020, Number 4

2020; 79 (4)