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Eur J Cardiothorac Surg 2006;30:808-810
© 2006 Elsevier Science NL

Case reports

Recurrent hyperparathyroidism: a sixth mediastinal parathyroid gland

Department of Thoracic Surgery, Rangueil-Larrey University Hospital, TSA 300 30, 24, chemin de Pouvourville, 31059 Toulouse, Cedex 9, France

Received 19 May 2006; received in revised form 24 June 2006; accepted 3 July 2006.

^_* Corresponding author. Tel.: +33 567 771 803; fax: +33 567 771 483. (Email: dahan.m{at}chu-toulouse.fr).

We present the case of a 71-year-old woman with recurrent hyperparathyroidism. She underwent first a subtotal resection of the parathyroid glands associated with subtotal thyroidectomy in the setting of primary hyperparathyroidism and multi nodular thyroid. Pathologic findings were consistent with hyperplasia and demonstrated a fifth parathyroid gland in the thyroid. Two years later, the patient presented recurrent hyperparathyroidism associated with terminal renal insufficiency, fusion of Sesta Mibi scintigraphy and CT scan demonstrated a sixth mediastinal parathyroid gland in the aorto pulmonary window. Despite videomediastinoscopic attempts, resection was performed through manubriotomy approach. Pathologic findings demonstrated a parathyroid adenoma.

Key Words: Hyperparathyroidism • Parathyroid gland • Adenoma • Hyperplasia • Manubriotomy • Videomediastinoscopy