Synchronous Parathyroidectomy and Extended Thymectomy in Multiple Endocrine Neoplasia Type 1

A 49-year-old man presented with symptoms of hypercalcemia that had been present for 3 months. An initial chest x-ray showed a large anterior mediastinal mass. Subsequent computed tomography also demonstrated a calcified lesion in the uncinate process of the pancreas, and a neck ultrasound showed parathyroid lesions. The combination of symptoms and tumors raised the possibility of multiple endocrine neoplasia type 1 as the diagnosis. The lesions were later biopsy-proven to be atypical carcinoid neuroendocrine tumors. The patient underwent simultaneous neck dissection for bilateral subtotal parathyroidectomy and midline sternotomy for thymectomy of the large mediastinal mass.