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Bao Y, Kang G, Wu X, Li J, Huang Y, Wang Y. Mediastinal parathyroid carcinoma: a case report and review of the literature. BMC Endocr Disord 2023; 23:130. [PMID: 37280629 DOI: 10.1186/s12902-023-01363-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 05/04/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Parathyroid carcinoma (PC) is an uncommon cause of primary hyperparathyroidism (PHPT) and particularly rare in the mediastinum. Herein, we present a case of mediastinal PC and conduct a related literature review. CASE PRESENTATION We described a case of a 50-year-old female patient with PHPT due to mediastinal PC. She was initially admitted to a local hospital in her hometown with hypercalcemia and high blood concentrations of PTH (parathyroid hormone). The patient underwent neck parathyroidectomy and pathological examination suggested parathyroid adenoma. Although the overproduction of serum calcium and PTH declined after the surgery, calcium and PTH increased again one month later, so the patient was transferred to our hospital. A 99mTc-sestamibi scan revealed an ectopic finding in the mediastinum, which was also indicated on the CT image. After removing the mediastinal mass, the metabolism of calcium and PTH quickly reverted to normal and the pathologic features of the mass were consistent with PC. By reviewing the related literature, we noticed that only scattered reports were published before 1982, and those were not included in the present review due to their differences with current radiological examination and treatment methods. After excluding outdated studies, we summarized and analyzed 20 reports of isolated mediastinal PC and concluded that. Parathyroidectomy remains the only curative treatment for the disease. Furthermore, the success of treatment directly depends on accurate preoperative localization. CONCLUSION With this study, we emphasize the importance of accurate preoperative diagnosis of mediastinal PC and improve clinicians' understanding of the disease.
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Affiliation(s)
- Yan Bao
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
- Present address: Department of Endocrinology, Renmin Hospital of Wuhan University, Jiefang Road 238, Wuhan, Hubei, 430060, China.
| | - Ganjun Kang
- Departments of Thoracic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Xiaoyan Wu
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jing Li
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Yan Huang
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Ye Wang
- Department of Endocrinology, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
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Patrinos A, Zarokosta M, Piperos T, Tsiaoussis J, Noussios G, Mariolis-Sapsakos T. An anatomic aberration and a surgical challenge: Mediastinal parathyroid adenoma anterior the pericardium. A case report. Int J Surg Case Rep 2019; 58:153-156. [PMID: 31048210 PMCID: PMC6495084 DOI: 10.1016/j.ijscr.2019.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/26/2019] [Accepted: 04/03/2019] [Indexed: 11/23/2022] Open
Abstract
Ectopic parathyroid adenomas located deeper in the mediastinum remain a surgical challenge. Their incidence reaches up to 20% of the general population and they tend to constitute a severe cause of failed primary surgery for PHPT. Such aberrations seem to be more common than described in the literature and there are possible anatomic aberrations that have not been described yet. Preoperative detection of the mediastinal parathyroid adenoma and detailed exposure of the operative field are essential for a safe mid-sternal thoracotomy.
Introduction Ectopic parathyroid glands occur in 6–16% of cases of PHPT and they constitute a potential cause of failed primary surgical therapy. In particular, aberrant adenomas located deeper in the mediastinum, as in the presented case, remain a severe challenge for the surgeons. Presentation of case A 54-year-old Caucasian female proceeded to our institution with signs and symptoms of PHPT. Imaging studies performed identified a large mass localized in the lower anterior mediastinum, on the left of the median line. A mid-sternal thoracotomy was performed and the aberrant adenoma was finally detected anterior to the pericardium and the left pericardiophrenic vessels and the left phrenic nerve. The operation was uneventful. A meticulous review of the literature was conducted as well. Discussion Single parathyroid adenomas are the key culprits of PHPT. Anatomic aberrations of the location of the parathyroid glands and their adenomas are more common than described in the literature and there are possible anatomic aberrations that have not been described yet. All these anatomic variations constitute major risk-factors of thoracic bleeding and of nerve injury. Conclusion Detailed preoperative detection in addition to meticulous exposure of the operative field are fundamental in order to perform a safe adenoma excision without harmful impacts to the patient.
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Affiliation(s)
- Antonios Patrinos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece
| | - Maria Zarokosta
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri'', Athens, Greece.
| | - Theodoros Piperos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri'', Athens, Greece
| | - John Tsiaoussis
- University Department of Anatomy, Faculty of Medicine, University of Crete, Greece
| | - George Noussios
- Department of Anatomy, School of Physical Education and Sport Sciences, Serres, Aristotles University of Thessaloniki, Greece
| | - Theodoros Mariolis-Sapsakos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri'', Athens, Greece
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Patrinos A, Zarokosta M, Piperos T, Chrysikos D, Kakaviatos D, Theodoropoulos P, Kalles V, Tsiaoussis J, Noussios G, Mariolis-Sapsako T. WITHDRAWN: An anatomic aberration and a surgical challenge: Mediastinal parathyroid adenoma anterior the pericardium. A case report. Int J Surg Case Rep 2019; 57:106-109. [PMID: 30943449 PMCID: PMC6444067 DOI: 10.1016/j.ijscr.2019.03.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/08/2019] [Accepted: 03/05/2019] [Indexed: 11/17/2022] Open
Abstract
Massive localized lymphedema (MLL) constitutes a rare benign clinical disorder, presenting in obese patients, characterized by chronic accumulation of lymph and adipose tissue due to lymphatic flow obstruction. MLL may mimic an abundance of soft tissue tumors. Nevertheless, surgical excision of the soft-tissue mass, seems the most favorable therapeutic approach, as performed in the presented case.
Introduction: Ectopic parathyroid glands occur in 6–16% of cases of PHPT and they constitute a potential cause of failed primary surgical therapy. In particular, aberrant adenomas located deeper in the mediastinum, as in the presented case, remain a severe challenge for the surgeons. Presentation of case: A 54-year-old Caucasian female proceeded to our institution with signs and symptoms of PHPT. Imaging studies performed identified a large mass localized in the lower anterior mediastinum, on the left of the median line. A mid-sternal thoracotomy was performed and the aberrant adenoma was finally detected anterior to the pericardium and the left pericardiophrenic vessels and the left phrenic nerve. The operation was uneventful. A meticulous review of the literature was conducted as well. Discussion: Single parathyroid adenomas are the key culprits of PHPT. Anatomic aberrations of the location of the parathyroid glands and their adenomas are more common than described in the literature and there are possible anatomic aberrations that have not been described yet. All these anatomic variations constitute major risk-factors of thoracic bleeding and of nerve injury. Conclusion: Detailed preoperative detection in addition to meticulous exposure of the operative field are fundamental in order to perform a safe adenoma excision without harmful impacts to the patient.
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Affiliation(s)
- Antonios Patrinos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece
| | - Maria Zarokosta
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece.
| | - Theodoros Piperos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Dimosthenis Chrysikos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Dimosthenis Kakaviatos
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Panagiotis Theodoropoulos
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - Vasileios Kalles
- University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
| | - John Tsiaoussis
- University Department of Anatomy, Faculty of Medicine, University of Crete, Greece
| | - George Noussios
- Department of Anatomy, School of Physical Education and Sport Sciences, Serres, Aristotles University of Thessaloniki, Greece
| | - Theodoros Mariolis-Sapsako
- Anatomy and Histology Laboratory, School of Nursing, University of Athens, Greece; University Department of Surgery, General and Oncologic Hospital of Kifissia "Agii Anargiri", Athens, Greece
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Liu X, Sun L, Shao M, Li P, Liu W, Zhang X, Zhang L, Ma Y, Li W. Primary hyperparathyroidism due to ectopic parathyroid adenoma in an adolescent: a case report and review of the literature. Endocrine 2019; 64:38-42. [PMID: 30805889 DOI: 10.1007/s12020-019-01875-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Accepted: 02/15/2019] [Indexed: 11/28/2022]
Abstract
PURPOSE Primary hyperparathyroidism (PHPT) is a common endocrine disorder and is usually diagnosed in adults. PHPT due to ectopic parathyroid adenoma in adolescents is rare. METHODS We describe the case of a 15-year-old boy with PHPT due to ectopic parathyroid adenoma. A review of the literature of PHPT in adolescents was performed, focusing on etiology, clinical presentation, preoperative localization methods, pathology, and treatment. RESULTS The patient was successfully treated with surgery and was followed up for 5 years with no signs or symptoms of hyperparathyroidism. By reviewing the literature, only seven cases of PHPT associated with ectopic parathyroid lesions in adolescents have been reported. Parathyroidectomy is the only known curative treatment. Accurate preoperative localization of the target lesion is critical. CONCLUSIONS This study should raise awareness of the diagnosis and treatment of PHPT due to ectopic parathyroid adenoma/carcinoma in adolescents.
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Affiliation(s)
- Xiangli Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Lei Sun
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Mingrui Shao
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - PeiWen Li
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Wenke Liu
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Xinyu Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Lin Zhang
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yingjun Ma
- Department of Thoracic Surgery, Meihekou City Central Hospital, Meihekou, Jilin Province, China
| | - Wenya Li
- Department of Thoracic Surgery, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning Province, China.
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