Aortopulmonary ectopic parathyroid gland and concurrent thymolipoma

Area of Science:

• Endocrinology
• Surgical Pathology
• Medical Imaging

Background:

• Ectopic parathyroid adenomas are a primary cause of primary hyperparathyroidism.
• Concurrent parathyroid and thymic pathologies are infrequently diagnosed.
• Myasthenia gravis can be associated with thymic abnormalities.

Observation:

• A 47-year-old male with diabetes, hypertension, and myasthenia gravis presented with persistent hypercalcemia.
• Imaging revealed ectopic parathyroid glands, a mediastinal mass, and an enlarged thymus.
• The patient had a history of myasthenia gravis, suggesting a potential link to thymic pathology.

Findings:

• Surgical exploration and excision via median sternotomy were performed.
• Histopathology confirmed ectopic parathyroid adenoma and thymolipoma.
• Post-operative normalization of serum calcium and parathormone levels within 48 hours.

Implications:

• This case underscores the diagnostic challenge of ectopic parathyroid adenomas.
• Concurrent thymic pathology necessitates careful surgical planning and execution.
• Successful surgical management of ectopic parathyroid adenoma and thymolipoma can effectively resolve hypercalcemia.