Archive of Old Cases
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- Archive of Old Cases
- 2015
Case No : 920 Date 2015-06-15
- Courtesy of Mi Jung Park, Kyung Nyeo Jeon / Gyeongsang National University
- Age/Sex 27 / F
- Chief ComplaintChronic fatigue
Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Ectopic parathyroid adenoma
- Radiologic Findings
- A small, well enhancing nodule was seen in the anterior mediastinum, abutting the superior vena cava. Hyperthyroidism (PTH level: 182 pg/ml (15-65) and hypercalcemia were observed in this patient. She underwent surgery and parathyroid and calcium levels were normal after surgery.
- Brief Review
- Parathyroid glands are derived from the third and fourth branchial pouches. In patients with persistent hyperparathyroidism after adequate parathyroid surgery, ectopic adenoma or hyperplastic glands located in the mediastinum must be considered. 80% of these tumors are located in the anterior mediastinum, along the thymopharyngeal duct tract, extending from the angle of the mandible to the lower anterior mediastinum. Patients with profound hypercalcemia tend to have larger tumors. Although some ectopic lesions are located within the thymus, most mediastinal extrathymic parathyroid adenomas can be recognized on CT as small, round masses, 1-2 cm in diameter, in the upper portion of the anterior mediastinum. Small, isolated lymph nodes in this area can resemble an adenoma. Functioning mediastinal parathyroid cysts have rarely been reported. On 99mTc-sestamibi scintigraphy, parathyroid adenoma shows focal increased radiotracer uptake on early and delayed phases.
- Please refer to Case 920,
- References
- Brown, L. R., & Aughenbaugh, G. L. (1991). Masses of the anterior mediastinum: CT and MR imaging. AJR. American journal of roentgenology,157(6), 1171-1180.
Smith, J. R., & Oates, M. E. (2004). Radionuclide imaging of the parathyroid glands: patterns, pearls, and pitfalls. Radiographics, 24(4), 1101-1115.
- Keywords
- Mediastinum, Benign tumor,
No. of Applicants : 90
- ▶ Correct Answer : 18/90, 20.0%
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- - Ewha Womans University Hospital , Korea (South) YOOKYUNG KIM
- - Christian medical college vellore , India Abhishek Khurana
- - Yokohama-asahi-chuo-general hospital , Japan Kyoko Nagai
- - GHICL , France manuel toledano
- - Niigata City General Hospital , Japan Takao Kiguchi
- - Asan Medical Center , Korea (South) Hyung Jung Koo
- - Asan medical center , Korea (South) Sang Young Oh
- - Asan , Korea (South) Sania ALBlushi
- - Asan Medical Center, Ulsan University , Korea (South) Mi Young Kim
- - Hanyang universitiy, radiology department , Korea (South) HyunGyu Lee
- - Okinawa Kyodo Hospital , Japan Shoko Iraha
- - chungbuk university hospital , Korea (South) Hyeonmi Ryu
- - chungbuk national university hospital , Korea (South) lee jung hwan
- - chungbuk national university hospital , Korea (South) soojung lee
- - the first affiliatited hospital of nanjing medical univercity , China Hai Xu
- - chungbuk national university hospital , Korea (South) jeehye kim
- - Seirei Hamamatsu General Hospital , Japan Kenichi Mizuki
- - National Center hospital of Neurology and Psychiatry , Japan Kaoru Sumida
- ▶ Correct Answer as Differential Diagnosis : 7/90, 7.8%
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- - Avrasya Hospital , Turkey Murat Ulusoy
- - IRSA La Rochelle , France Denis Chabassiere
- - McGill University Health Center , Canada Alexandre Semionov
- - Asan Medical Center , Korea (South) Soyeoun Lim
- - IRSA LA ROCHELLE , France, Metropolitan BIGOT
- - Pneumologia Universitaria, Policlinico di Bari , Italy Mario Damiani
- - Niigata University , Japan Atsushi Uehara
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