Primary hyperparathyroidism caused by a mediastinal parathyroid adenoma
DOI:
https://doi.org/10.51481/amc.v57i2.882Keywords:
hyperparathyroidism, hypercalcemia, parathyroid hormoneAbstract
Primary hyperparathyroidism results from an increased secretion of parathyroid hormone (PTH) into the blood stream, its most common etiology is an adenoma of the parathyroid gland, which causes hypercalcaemia. Classically a patient presents elevated serum calcium and PTH levels, associated with imaging studies. The treatment consists of surgical excision with high rates of success.
We present the case of a 63-year old hypertensive female, with a history of loss of appetite and general weakness for the last year and a half. Laboratory exams showed hypercalcaemia and an elevated PTH. A Tc 99 scan revealed an 18 mm nodule, located 2 cm caudal to the right thyroidal lobe. A neck exploration was performed but an adenoma could not be located, so a median sternotomy was then requested and a superior mediastinal adenoma, posterior to the right brachiocephalic vein was found and resected. Laboratory controls done 24-hour later revealed normal PTH and serum calcium levels and the patient was discharged.
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