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Unusual Ectopic Parathyroid Adenoma: A Case Report.
Habibeh Taghavi Kojidi1, Nazanin Vagharimehr1, Shahrzad Mohseni1
1Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Acta Medica Iranica
|October 5, 2016
Summary
A large, 75-gram ectopic parathyroid adenoma in the mediastinum caused severe hyperparathyroidism in a patient. This rare case highlights unusual presentations of persistent primary hyperparathyroidism.
Area of Science:
- Endocrinology
- Surgical Pathology
- Nuclear Medicine
Background:
- Ectopic parathyroid adenomas in the mediastinum are uncommon causes of persistent or recurrent primary hyperparathyroidism.
- Large mediastinal parathyroid tumors are exceptionally rare, posing diagnostic and surgical challenges.
Observation:
- A 70-year-old male with a history of parathyroidectomy and thymectomy presented with symptoms of severe hypercalcemia, including nausea, bone pain, and polydipsia.
- Diagnostic imaging, specifically 99mTc-sestamibi scintigraphy with SPECT, identified a focal area of radiotracer uptake in the anterior chest wall at the xiphoid level.
Findings:
- Surgical excision revealed a massive 75-gram parathyroid adenoma in the mediastinum.
- Histopathological analysis confirmed the diagnosis of parathyroid adenoma.
Implications:
- This case underscores the importance of considering ectopic mediastinal parathyroid adenomas, even when unusually large, in patients with persistent hyperparathyroidism.
- Advanced imaging techniques are crucial for localizing these rare ectopic tumors.
- Management requires surgical expertise due to the tumor's size and location.
