title: Video Assisted Thoracoscopic Surgery (VATS) for Excision of an Ectopic Anterior Mediastinal Intra-Thymic Parathyroid Adenoma.
abstract: Ectopic anterior mediastinal parathyroid adenoma is a rare cause of Primary Hyperparathyroidism (PHPT). Imaging studies such as Technetium-99m ((99m)Tc) sestamibi parathyroid scan along with a Single Photon Emission Computerized Tomogram (SPECT), and contrast enhanced Computerized Tomogram (CT) of the neck and thorax can precisely localize the ectopic mediastinal parathyroid adenoma. We report a 40-year-old gentleman who presented with persistent pain in the right shoulder following trivial trauma. His biochemical investigations showed an elevated serum calcium of 11.6mg% (Normal: 8.3-10.4 mg%) along with an elevated iPTH of 1443 pg/ml (normal: 8-70 pg/ml) which were suggestive of primary hyperparathyroidism. The localization studies revealed an ectopic cystic parathyroid adenoma in the anterior mediastinum that was not accessible from the neck. He underwent a Video Assisted Thoracoscopic (VAT) excision procedure with normalization of serum calcium and an uncomplicated recovery. The VAT approach is a successful minimally invasive technique for mediastinal parathyroidectomy.
authors: Associate Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College , Vellore, India .
authors: Dukhabandhu
authors: D
authors: Naik
authors: Senior Registrar, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College , Vellore, India .
authors: Kumaradoss Felix
authors: KF
authors: Jebasingh
authors: Assistant Professor, Department of Thoracic surgery, Christian Medical College , Vellore, India .
authors: Ramprasath
authors: Professor, Department of Thoracic Surgery, Christian Medical College , Vellore, India .
authors: Gnanamuthu Birla
authors: GB
authors: Roy
authors: Professor and Head, Department of Endocrine Surgery, Christian Medical College , Vellore, India .
authors: Mazhuvanchary Jacob
authors: MJ
authors: Paul
keywords: Minimally invasive technique; Primary hyperparathyroidism; Sestamibi parathyroid scan