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,