title: Mediastinal parathyroid adenoma: diagnostic and management challenges.
abstract: Primary hyperparathyroidism due to ectopic parathyroid adenomas can pose diagnostic and management challenges, especially when imaging studies have localised the lesions to different sites. We report a case of symptomatic hypercalcaemia due to a mediastinal parathyroid adenoma. Ultrasonography identified a nodule posterior to the right thyroid gland. However, computed tomography and technetium-99m sestamibi scintigraphy revealed an ectopic parathyroid adenoma located in the anterior mediastinum. The adenoma was successfully removed through a median sternotomy. However, postoperatively, the patient developed prolonged symptomatic hypocalcaemia, possibly due to suppression of the normal parathyroid gland function, although the presence of concomitant hungry bone syndrome was possible. The histopathology of the mediastinal mass was consistent with a parathyroid adenoma.
authors.affiliation: Endocrine Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Malaysia. shahck@kb.usm.my
authors.forename: S
authors.initials: S
authors.lastname: Che Kadir
authors.forename: B E
authors.initials: BE
authors.lastname: Mustaffa
authors.forename: Z
authors.initials: Z
authors.lastname: Ghazali
authors.forename: Z
authors.initials: Z
authors.lastname: Hasan
authors.forename: A H
authors.initials: AH
authors.lastname: Imisairi
authors.forename: S
authors.initials: S
authors.lastname: Mustafa
mesh_terms: D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D006961:Hyperparathyroidism / Q000175:diagnosis; D006996:Hypocalcemia / Q000188:drug therapy / Q000209:etiology; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D008875:Middle Aged; D010280:Parathyroid Glands / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D011183:Postoperative Complications; D017256:Technetium Tc 99m Sestamibi / Q000494:pharmacology; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D017256:Technetium Tc 99m Sestamibi; D002118:Calcium