Related Experiment Video
Updated: May 27, 2026
07:43
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Giant mediastinal parathyroid adenoma.
Hüseyin Cakmak1, Arif Osman Tokat, Sezgin Karasu
1Clinic of Chest Surgery, Ankara Training and Research Hospital, Ankara, Turkey.
Tuberkuloz Ve Toraks
|November 18, 2011
Summary
A rare, giant mediastinal parathyroid adenoma caused hypercalcemia in a 63-year-old female. This ectopic adenoma, the largest reported, was surgically removed, offering insights into unusual presentations of primary hyperparathyroidism.
Area of Science:
- Endocrinology
- Surgical Pathology
Background:
- Primary hyperparathyroidism typically results from parathyroid adenoma or hyperplasia.
- Parathyroid adenomas can exceptionally grow to massive sizes.
Observation:
- A 63-year-old female presented with hypercalcemia and a mediastinal mass.
- Diagnostic evaluation revealed an ectopic, hypersecretory parathyroid adenoma with elevated intact parathormone levels (642 pg/mL).
Findings:
- Surgical resection via a right thoracic approach was performed.
- The resected parathyroid adenoma measured 7 x 5 x 4 cm and weighed 145 g, representing the largest documented case in the literature.
- Despite its significant size, the adenoma caused minimal hypercalcemic symptoms.
Implications:
- This case highlights the potential for massive ectopic parathyroid adenomas to develop in the mediastinum.
- It underscores the importance of considering ectopic hormone-secreting tumors in the differential diagnosis of hypercalcemia.
- The unusual presentation emphasizes the variability in symptom manifestation despite tumor burden.
Related Concept Videos
00:59The Parathyroid Glands
The two pairs of parathyroid glands embedded within the posterior surface of the thyroid gland are restricted by a dense capsule around them. These glands comprise two distinct cell populations—parathyroid oxyphil and parathyroid principal cells- pivotal in calcium homeostasis.
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...
Oxyphil cells, whose functions remain elusive, emerge during late puberty, adding a layer of complexity to the parathyroid gland's intricacies. In contrast, principal parathyroid cells undertake a vital role by producing...
01:27Goiter
Goiter refers to an abnormal enlargement of the thyroid gland that may appear as a diffuse goiter (uniform enlargement) or nodular (single or multiple nodules). Functionally, it is classified as nontoxic (normal/low hormone levels) or toxic (excess hormone production).PathophysiologyDiffuse thyroid enlargement typically results from prolonged stimulation by thyroid-stimulating hormone (TSH) or TSH-like agents, commonly seen in hypothyroidism or iodine deficiency. In contrast, in hyperthyroid...
01:27Hyperthyroidism II: Pathophysiology
Hyperthyroidism is a hypermetabolic state caused by elevated levels of thyroid hormones, triiodothyronine (T3) and thyroxine (T4). It results from dysregulation at the thyroid, pituitary, or immune system level and affects multiple organ systems.PathophysiologyThe most common cause of hyperthyroidism is Graves’ disease, an autoimmune disorder in which antibodies, specifically thyroid-stimulating antibodies (TSAb), a subtype of TSH receptor antibodies (TRAb), bind to and activate TSH receptors...
01:25Hyperthyroidism I: Introduction
Hyperthyroidism is a type of thyrotoxicosis characterized by the thyroid gland's overproduction of the thyroid hormones triiodothyronine (T3) and thyroxine (T4). This hormone excess increases the basal metabolic rate and enhances sensitivity to catecholamines.DiagnosisDiagnosis is based on clinical features and biochemical testing. It typically shows suppressed thyroid-stimulating hormone (TSH) levels below 0.4 mIU/L, with elevated free T3 and/or T4. Additional tests, including thyroid...
01:19Appendicitis
Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
01:24Graves Disease II: Pathophysiology
Graves’ disease is an autoimmune disorder characterized by the production of thyroid-stimulating immunoglobulins (TSI) that activate TSH receptors, leading to excessive synthesis and release of thyroid hormones (T3 and T4) and resulting in hyperthyroidism.Among all causes of hyperthyroidism, Graves’ disease is the most common and can happen at any age, though it is more frequent in women. It produces a hypermetabolic state with features such as weight loss, tachycardia, tremor, and heat...