Thoracoscopic removal of a retrosternal parathyroid adenoma

Abstract

Primary hyperthyroidism is a common endocrine pathology, with parathyroid adenoma being the most frequent cause of this condition. A number of patients have deep-seated mediastinal adenomas which poses certain challenges in diagnostics and impose serious limitations for performing a surgery using a traditional transcervical approach. Nonetheless, the combination of modern tools of topical diagnostic investigations along with mini-invasive surgical methods allow to perform a radical operation in this group of patients with reduced injury rate. In this article we present a clinical case of surgical treatment of a 65-Year-Old female patient with primary hyperthyroidism caused by retrosternal parathyroid adenoma located in the aortic-pulmonal window. Preliminary diagnosis was based on Chest Computed Tomography (CCT scan) and technetium-99mTC scintigraphy. Considering complex anatomical and topographical location of the tumour it was decided to perform a thoracoscopic parathyroidectomy. The postoperative period was uneventful, with the laboratory values of parathormone being within reference range after the surgery. On the third day after the operation the patient was discharged. Further follow-up has not shown any signs of relapse.