[Thoracoscopic resection of mediastinal hypersecretant parathyroid gland].
In general experienced hands, the inferior parathyroid glands, localized in the thymus or low extrathymus are the main cause or surgical therapeutic failure. When they could not be approached through cervicotomy, or when they were diagnosed after surgery the sternotomy or the angiographic ablation were chosen as treatment. The limited number of thoracoscopic approach whit good results published so far, moved us to use this method.


METHODS
Patient of 49 years with a 7 year secondary hiperprathyroidism due to CRI. After a sub total parathyroidectomy with bilateral thimectomy, the patient did not present clinical or laboratory improvement. Through a thoracic centellogram sixth MIBI, NMR and CAT, a tumor in the middle mediastinum was fond. The mediastinal structures have been easily identified through a left thoracoscopic approach. At the level of the aortopulmonary window, a tumoral mass is located and, with a simple dissection, et is easily extracted in bag. The biopsy through freezing confirms the parathyroid etiology of the gland.


RESULTS
Clinical and laboratory evolution has been favorable, with hospital discharged at the 3 day, and being asymptomatic after two years.


CONCLUSIONS
The hipersecretant parathyroid glands, located in middle mediastinum, that can not be approach through cervicotomy, can be successfully approach through thoracoscopic technique.
Gramática
Luis
L
Clínica Sucre S.R.L. Santa Rosa 770. CP:5000 Córdoba, Argentina.
Mercado Luna
Andrés
A
Verasay
Guillermo
G
Brizuela
Adrián
A
Gramática
Luis
L
D000236:Adenoma / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D006962:Hyperparathyroidism, Secondary / Q000150:complications / Q000473:pathology / Q000601:surgery; D007676:Kidney Failure, Chronic / Q000150:complications; D008479:Mediastinal Neoplasms / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology / Q000601:surgery*; D016105:Parathyroidectomy; D013906:Thoracoscopy; D016896:Treatment Outcome