Hemead Hanan M, Abdellatif Ahmed Abdelaziz, Abdel Rahman Mostafa A
Alexandria Faculty of Medicine, Champollion Street, Al Mesallah Sharq, Al Attarin, Alexandria Governorate, Egypt.
Alexandria Faculty of Medicine, Champollion Street, Al Mesallah Sharq, Al Attarin, Alexandria Governorate, Egypt.
Int J Surg Case Rep. 2022 Jan;90:106598. doi: 10.1016/j.ijscr.2021.106598. Epub 2021 Nov 12.
The ectopic parathyroid adenoma is an important cause of refractory and recurrent hyperparathyroidism. The mediastinal location of ectopic parathyroid tissue is reported in up to 20% of cases of ectopic parathyroid adenomas. In around 2% of cases where cervical approach is unfeasible, the mediastinal route imposes a surgical challenge.
We describe a case of a twenty-five-year-old male patient with manifestations of hyperparathyroidism. Computed tomography of the chest showed an anterior mediastinal mass. Nuclear scintigraphy detected a functioning parathyroid tissue in the mediastinum. The mass was excised en block with the surrounding adipose tissue using a three-port video-assisted thoracoscopic surgery. The patient showed a full symptomatic and laboratory recovery.
Mediastinal parathyroid glands comprise a unique surgical entity with diagnostic and management difficulties.
Mediastinal parathyroid gland is a rare yet important cause of refractory hypercalcemia. The current localization tools improve the thoracoscopic management of MPAs. VATS can provide access and exposure to ectopic parathyroid adenoma with low morbidity.
异位甲状旁腺腺瘤是难治性和复发性甲状旁腺功能亢进的重要原因。据报道，高达20%的异位甲状旁腺腺瘤病例中存在异位甲状旁腺组织的纵隔位置。在约2%无法采用颈部入路的病例中，纵隔入路带来了手术挑战。
我们描述了一例25岁男性甲状旁腺功能亢进患者。胸部计算机断层扫描显示前纵隔肿块。核素显像检测到纵隔内有功能的甲状旁腺组织。采用三孔电视辅助胸腔镜手术将肿块与周围脂肪组织整块切除。患者症状和实验室检查结果完全恢复。
纵隔甲状旁腺构成了一个独特的外科实体，在诊断和管理方面存在困难。
纵隔甲状旁腺是难治性高钙血症的罕见但重要原因。当前的定位工具改善了纵隔甲状旁腺腺瘤的胸腔镜管理。电视辅助胸腔镜手术能够以较低的发病率对异位甲状旁腺腺瘤进行探查和暴露。
