[A case of mediastinal parathyroid adenoma with primary hyperparathyroidism]

A 21-year-old man with a history of recurrent urolithiasis was admitted. Hypercalcemia was found and a diagnosis of primary hyperparathyroidism was made. Neck exploration was performed without success. Localization studies were done. Repeated selective arteriography revealed a mediastinal parathyroid adenoma. CT scan as well showed the adenoma in the anterior mediastinum. Ultrasonotomography, 201Tl-chloride and 131I scintigraphy with subtraction image and two venous samplings were negative. Mediastinal exploration with partial sternotomy was performed and a parathyroid adenoma was subsequently removed. Serum calcium and phosphorous levels were normalized, several postoperative days.