Resection of Mediastinal Parathyroid Adenoma with Primary Hyperparathyroidism: Transcervical Approach

Abstract

Primary hyperparathyroidism (PHPT) arises from the abnormality of one or more parathyroid glands, resulting in increased levels of circulating PTH, leading to changes in the body, such as increased osteoclastic activity and increased renal absorption of calcium from the gastrointestinal tract. The main cause of PHPT is the presence of adenomas in the parathyroids, with approximately 10% of these adenomas being ectopically located, generally within the thymic gland in the anterior mediastinum. The surgical approach for ectopic mediastinal glands can be transcervical, transthoracic, via median sternotomy or thoracoscopic. Currently, there is no defined standard for the resection of ectopic parathyroid adenomas located in the mediastinum; the preferred technique depends on the surgeon’s experience and the location of the gland. Parathyroidectomy is the only definitive cure for PHPT, with cure rates exceeding 95% in experienced hands.