In parathyroid surgery, the incidence of ectopic parathyroid glands was 6.3% to 16%. In parathyroid gland reoperation, the incidence of ectopic parathyroid glands was 45%. The inferior parathyroid gland is most common ectopic located in the former mediastinum, often embedded in the thymus. The superior parathyroid gland is often located in the posterior longitudinal mediastinum. According to the reports, Primary Hyperparathyroidism (PHPT) caused by mediastinal parathayroid adenoma has a more severe clinical manifestation and higher serum calcium more likely to have bone involvement. Therefore, early diagnosis of mediastinal ectopic parathyroid adenoma is essential. When PTH and calcium ions was elevated and diagnosis of primary hyperparathyroidism was clear, if Tc-99m-MIBI scintigraphy was negative, ectopic parathyroid glands might need to be considered. We need choose other auxiliary examination methods such as neck-chest CT or MRI, and expand the scope of the Tc-99m-MIBI scan, including the neck and mediastinum. Understand the predilection sites of ectopic parathyroid glands, frequency, and its scoping, helps to locate ectopic parathyroid before and during surgery. The uptake of Tc-99m-MIBI has been associated with factors such as blood flow, size, and mitochondrial activity in parathyroid hyperplasia/adenomas. When parathyroid adenoma cystic degeneration occurs, located in the thyroid, small in size, asymmetrically hyperplastic or when the function is not significant, Tc-99m-MIBI is easy to show false negatives. The results of false positives in the mediastinum may be metastatic lung cancer, thymomas, seminomas, or lymphomas. Raising awareness of ectopic parathyroids to reduce clinical missed, misdiagnosed and easily to find ectopic parathyroid glands is of great help. Our hospital had treated a case of PHPT caused by ectopic parathayroid adenoma in the mediastinal, now reported as follows.
[1]Jilin Univ, Hosp 1, Dept ICU Grp 1, Changchun, Jilin, Peoples R China.
[2]Jilin Univ, Hosp 1, Dept Operating Room 1, Changchun, Jilin, Peoples R China.
[3]Jilin Univ, Hosp 1, Dept Thyroid Surg, Changchun, Jilin, Peoples R China.
[4]Jilin Univ, China Japan Union Hosp, Dept Orthopaed Surg, Changchun, Jilin, Peoples R China.
(8.0+极速模式)