Thoracoscopic excision of mediastinal parathyroid adenomas: a report of two cases

Two patients with primary hyperparathyroidism caused by solitary ectopic mediastinal parathyroid adenomas have been successfully treated by thoracoscopic excision. The patients were not suitable for open thoracic surgery. Both had right-sided adenomas confirmed by sestamibi and computerised tomograp...

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Bibliographic Details
Published in:Annals of the Royal College of Surgeons of England 2008-03, Vol.90 (2), p.W1-5
Main Authors: Burger, A E E, Skene, A I, Lagattolla, N R F
Format: Article
Language:English
Subjects:
Adenoma - complications
Adenoma - surgery
Aged
Female
Humans
Hyperparathyroidism, Primary - etiology
Male
Mediastinal Neoplasms - complications
Mediastinal Neoplasms - surgery
New Online Case Reports
Parathyroid Neoplasms - complications
Parathyroid Neoplasms - surgery
Radiopharmaceuticals
Technetium Tc 99m Sestamibi
Thoracic Surgery, Video-Assisted
Tomography, Emission-Computed, Single-Photon
Tomography, X-Ray Computed
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Summary:Two patients with primary hyperparathyroidism caused by solitary ectopic mediastinal parathyroid adenomas have been successfully treated by thoracoscopic excision. The patients were not suitable for open thoracic surgery. Both had right-sided adenomas confirmed by sestamibi and computerised tomography - one adjacent to the oesophagus at the level of D3, the other anterolateral to the ascending aorta. Both procedures were performed through one 12-mm camera port and two 5-mm operating ports, and were uncomplicated, with 30-45 minutes skin-to-skin operating time. Both patients were well enough to be discharged the next day, and both rapidly became normocalcaemic. At follow-up, neither had developed any complications. In selected cases, where an ectopic adenoma lies immediately deep to the mediastinal pleura, thoracoscopic excision offers considerable advantage over open thoracic surgery.
ISSN:0035-8843
1478-7083
DOI:10.1308/147870808X257175