title: Preoperative Localization of Mediastinal Parathyroid Adenoma with Intra-arterial Methylene Blue.
abstract: Ectopic parathyroid is found in 16% of patients with hyperparathyroidism. 2% of ectopic parathyroid adenomas are not accessible to standard cervical excision. In such cases, video-assisted thoracoscopic resection is the recommended definitive treatment. We present a case of mediastinal parathyroid adenoma localized preoperatively by injecting methylene blue within a branch of the internal mammary artery that is supplying the adenoma. Intra-arterial methylene blue injection facilitated visualization and resection of the adenoma. The preoperative intra-arterial infusion of methylene blue appears to be an effective and safe method for localization of ectopic mediastinal parathyroid adenomas and allows rapid identification during thoracoscopic resection.
authors.affiliation: Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Rida
authors.initials: R
authors.lastname: Salman
authors.affiliation: Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mikhael G
authors.initials: MG
authors.lastname: Sebaaly
authors.affiliation: Department of General Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mohammad Rachad
authors.initials: MR
authors.lastname: Wehbe
authors.affiliation: Department of General Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Pierre
authors.initials: P
authors.lastname: Sfeir
authors.affiliation: Department of General Surgery, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Mohamad
authors.initials: M
authors.lastname: Khalife
authors.affiliation: Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon. mk00@aub.edu.lb.
authors.forename: Aghiad
authors.identifier: http://orcid.org/0000-0002-5029-8568
authors.initials: A
authors.lastname: Al-Kutoubi
mesh_terms: D015901:Angiography, Digital Subtraction / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008479:Mediastinal Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D008751:Methylene Blue; D008875:Middle Aged; D010280:Parathyroid Glands / Q000000981:diagnostic imaging / Q000601:surgery; D010282:Parathyroid Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*
chemical_list: D008751:Methylene Blue
keywords: Ectopic parathyroid; Methylene blue; Parathyroid adenoma