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[Ectopic parathyroid adenoma: a case report].

A Iwasaki1, T Sekihara, T Yoshioka

  • 1Department of Urology, Osaka University Medical School.

Hinyokika Kiyo. Acta Urologica Japonica
|May 1, 1991
PubMed
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Primary hyperparathyroidism caused kidney stones in a 69-year-old woman. Ectopic parathyroid adenoma in the mediastinum was successfully located using imaging and surgically removed.

Area of Science:

  • Endocrinology
  • Surgical Oncology
  • Medical Imaging

Background:

  • Primary hyperparathyroidism is a common endocrine disorder often caused by parathyroid adenomas.
  • Renal stones are a frequent complication of hyperparathyroidism due to altered calcium metabolism.
  • Ectopic parathyroid adenomas, though rare, can present diagnostic challenges, particularly when located outside the neck.

Observation:

  • A 69-year-old woman presented with bilateral renal stones and laboratory findings indicative of primary hyperparathyroidism.
  • Initial neck exploration, including hemithyroidectomy and thymectomy, did not identify the source of parathyroid hormone overproduction.
  • Localization studies were crucial for identifying an ectopic parathyroid adenoma in the upper mediastinum.

Findings:

Related Experiment Videos

  • Selective arteriography with digital subtraction, computed tomography, ultrasonotomography, and selective venous sampling collectively confirmed the presence and location of the ectopic parathyroid adenoma.
  • Surgical removal of the mediastinal parathyroid adenoma was successfully performed via partial sternotomy.
  • The case highlights the utility of advanced imaging techniques in diagnosing challenging cases of ectopic parathyroid adenomas.

    • Implications:

    • Accurate preoperative localization is essential for successful surgical management of ectopic parathyroid adenomas.
    • Multimodality imaging approaches can significantly improve the detection rates of non-localized parathyroid adenomas.
    • This case underscores the importance of considering ectopic locations when hyperparathyroidism is suspected but the source is not found in typical anatomical sites.