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Ectopic Parathyroid Adenoma: Surgical Correction and its Complication Management
S A Sunny1, A Singh, A B Adhikary
1Dr Mohammad Samir Azam Sunny, Medical Officer, Department of Cardiac Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Mymensingh Medical Journal : MMJ
|February 14, 2019
Summary
A mediastinal parathyroid adenoma caused a parathyroid crisis in a 65-year-old female. Surgical resection was successful, but acute limb ischemia developed post-operatively.
Area of Science:
- Endocrinology
- Cardiovascular Surgery
- Nuclear Medicine
Background:
- Ectopic parathyroid glands, commonly in the anterior mediastinum, are a significant cause of persistent and recurrent hyperparathyroidism.
- Hyperparathyroidism can lead to severe complications, including parathyroid crisis, characterized by markedly increased serum calcium and parathyroid hormone (PTH) levels.
Observation:
- A 65-year-old female presented with parathyroid crisis due to a mediastinal parathyroid adenoma.
- Imaging revealed a 25×20×15mm anterior mediastinal mass, confirmed as parathyroid adenoma/hyperplasia via Technetium-99m-sestamibi scintigraphy.
Findings:
- Surgical resection of the ectopic parathyroid adenoma was performed via median sternotomy.
- Post-operatively, the patient developed acute left upper limb ischemia of unknown etiology, requiring immediate surgical and medical management.
Implications:
- This case highlights the diagnostic and management challenges of ectopic mediastinal parathyroid adenomas.
- The occurrence of acute limb ischemia post-operatively underscores the need for vigilance and prompt intervention for unexpected complications in cardiac surgery patients.
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