Ectopic pure mediastinal parathyroid adenoma: A case report.

The ectopic parathyroid adenoma is an important cause of refractory and recurrent hyperparathyroidism. The mediastinal location of ectopic parathyroid tissue is reported in up to 20% of cases of ectopic parathyroid adenomas. In around 2% of cases where cervical approach is unfeasible, the mediastinal route imposes a surgical challenge. We describe a case of a twenty-five-year-old male patient with manifestations of hyperparathyroidism. Computed tomography of the chest showed an anterior mediastinal mass. Nuclear scintigraphy detected a functioning parathyroid tissue in the mediastinum. The mass was excised en block with the surrounding adipose tissue using a three-port video-assisted thoracoscopic surgery. The patient showed a full symptomatic and laboratory recovery. Mediastinal parathyroid glands comprise a unique surgical entity with diagnostic and management difficulties. Mediastinal parathyroid gland is a rare yet important cause of refractory hypercalcemia. The current localization tools improve the thoracoscopic management of MPAs. VATS can provide access and exposure to ectopic parathyroid adenoma with low morbidity. • Ectopic mediastinal parathyroid glands are rare yet challenging cause of refractory or recurrent hypercalcemia. • Most mediastinal parathyroids are approachable through a neck incision. • Larger, deeper or totally mediastinal glands require thoracic access. • Historically, in challenging cases, sternotomy or thoracotomy is performed with associated high morbidity in some cohorts. • The video-assisted thoracoscopic surgery (VATS) allows surgeons to retrieve these glands guided with localization tools. [ABSTRACT FROM AUTHOR]