Microwave ablation of ectopic mediastinal parathyroid: A case report

Secondary hyperparathyroidism is a common and serious complication of long-term hemodialysis in patients with chronic renal failure. Ectopic parathyroid is caused by migration defects during early development and contamination of parathyroid tissue during parathyroidectomy, which can lead to difficulty in identifying and treating due to the abnormal location of the proliferating parathyroid. This report describes a 41-year-old male patient with chronic renal failure who developed symptomatic hyperparathyroidism after 6 years of regular hemodialysis, with chest CT and parathyroid 99Tcm-MIBI examination showing hyperplasia of ectopic parathyroidism in the upper mediastinum. Subsequently, ultrasound-guided microwave ablation through suprasternal fossa was performed on the patient. After 1 year of postoperative follow-up, the patient's clinical symptoms were significantly improved, and the parathyroid hormone, blood calcium, and blood phosphorus were all controlled to an ideal level. Based on the successful treatment of this case, we believe that ultrasound-guided microwave ablation is an effective alternative for ectopic parathyroid hyperplasia, especially for patients who have difficulty tolerating conventional surgery.