[A new surgical technique for thoracic parathyroid glands: video-assisted thoracoscopy with intraoperative Tc-MIBI...

Ectopic mediastinal parathyroid glands are uncommon (1-11% of all cases of hyperparathyroidism). Median sternotomy used to be performed to resect them, with large and painful incisions that prolonged the length of hospital stay. Current imaging techniques (thoracic computed tomography and Tc-mibi scan) can accurately locate the ectopic glands, allowing minimally invasive exploration. We report a new surgical technique: video-assisted thoracoscopic resection associated with intraoperative Tc-mibi scintigraphy for ectopic mediastinal parathyroid glands. This technique allows minimally invasive access and reduces complications and length of hospital stay. Therefore we believe that video-assisted thoracoscopy could become the technique of choice in patients with high surgical risk and a fifth ectopic parathyroid gland. We report the case of a 49-year-old man in whom surgery was successful.