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Revista de la Facultad de Medicina (México)
On-line version ISSN 2448-4865Print version ISSN 0026-1742
Abstract
BARRIENTOS LOPEZ, Isaías Adrián and CASTILLO VENTURA, Bertha Beatriz. Transcervical Excision of a Giant Mediastinal Parathyroid Adenoma. Rev. Fac. Med. (Méx.) [online]. 2021, vol.64, n.2, pp.38-45. Epub July 06, 2021. ISSN 2448-4865. https://doi.org/10.22201/fm.24484865e.2021.64.2.06.
Primary hyperparathyroidism (HPTP) is the third most com- mon neuroendocrine disorder, its main cause is parathyroid adenoma. Within the classification, those adenomas that weigh more than 3.5 g are classified as giant parathyroid adenomas (APG), and are associated with a worse evolution and malignancy. The purpose of this article is to present our diagnostic and therapeutic approach of a patient with HPTP associated with a mediastinal APG. A search in the international literature of the last 10 years revealed that only 8 other centers have reported the extraction of an APG of similar dimensions to ours and in a similar location.
Case presentation:
A 66-year-old woman with a history of multinodular goiter, thyroid profile and parathormone (PTH) measurement were requested, with a report of 350.60 pg/ mL. A thyroid/parathyroid scintigraphy was performed with 99mTc sestaMIBI which reported persistence of a focal area of the concentration located in the topography of the lower pole of the right thyroid lobe. This study was complemented with SPECT-CT, which reported an image of hyperfunctioning right inferior parathyroid compatible with adenoma and the patient was diagnosed with PTH. Finally, resection was performed, obtaining a tumor measuring 7.0 × 4.5 × 2.0 cm, with a weight of 24.5 g.
Conclusions:
Our case highlights the use of imaging studies to facilitate localization and achieve diagnosis together with clinical presentation and biochemical profile. Selective treatment was achieved safely through a minimally invasive transcervical technique, combined with the measurement of PTH.
Keywords : Parathyroid adenoma; neoplasia; hypercalcemia; primary hyperparathyroidism; case report.
