Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism
IntroductionSecondary hyperparathyroidism (SHPT) is a common complication in hemodialysis patients with chronic renal failure uremia. For severe SHPT, parathyroidectomy is effective. Owing to the variability in parathyroid anatomy, surgical parathyroidectomy can be complex and many patients experien...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-07-01
|
| Series: | Frontiers in Surgery |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2022.921026/full |
| _version_ | 1811221641111273472 |
|---|---|
| author | Yong Lv Qiuyuan Wang Qiuyuan Wang Ling Zhang Qing Zhou Zhiyu Mi Yi Wu Jingning Cheng |
| author_facet | Yong Lv Qiuyuan Wang Qiuyuan Wang Ling Zhang Qing Zhou Zhiyu Mi Yi Wu Jingning Cheng |
| author_sort | Yong Lv |
| collection | DOAJ |
| description | IntroductionSecondary hyperparathyroidism (SHPT) is a common complication in hemodialysis patients with chronic renal failure uremia. For severe SHPT, parathyroidectomy is effective. Owing to the variability in parathyroid anatomy, surgical parathyroidectomy can be complex and many patients experience recurrent SHPT, which may require repeated surgery. These cases pose significant challenges to surgeons.Case descriptionAn elderly woman with recurrent severe SHPT was admitted to our hospital. Preoperative methoxyisobutylisonitrile (MIBI) examination found a large ectopic parathyroid gland in the superior mediastinum, and she underwent reoperative parathyroidectomy. A large parathyroid gland in the right anterior mediastinum and another parathyroid gland in the left lingual lobe of the thymus were removed. The patient had postoperative hypocalcemia that was successfully corrected with calcium supplementation via femoral vein catheterization. During the 1-year postoperative follow-up, the patient's iPTH was well controlled and her blood calcium was within the normal range.ConclusionWe report a case of parathyroidectomy to remove multifocal ectopic hyperplastic parathyroid tissue in the mediastinum. Preoperative MIBI accurately detected the lesions. Calcium supplementation via femoral vein catheterization successfully corrected postoperative hypocalcemia. Postoperative follow-up for 1 year indicated that the surgery was successful. |
| first_indexed | 2024-04-12T08:02:57Z |
| format | Article |
| id | doaj.art-1af4ab1cdf134dd0a4aaee49cb3f93a1 |
| institution | Directory Open Access Journal |
| issn | 2296-875X |
| language | English |
| last_indexed | 2024-04-12T08:02:57Z |
| publishDate | 2022-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Surgery |
| spelling | doaj.art-1af4ab1cdf134dd0a4aaee49cb3f93a12022-12-22T03:41:14ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2022-07-01910.3389/fsurg.2022.921026921026Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidismYong Lv0Qiuyuan Wang1Qiuyuan Wang2Ling Zhang3Qing Zhou4Zhiyu Mi5Yi Wu6Jingning Cheng7Department of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Orthopaedic Surgery, China-Japan Friendship Hospital, Beijing, ChinaGraduate School of Beijing University of Chinese Medicine, Beijing, ChinaDepartment of Nephrology, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, ChinaDepartment of Otolaryngology-Head and Neck Surgery, China-Japan Friendship Hospital, Beijing, ChinaIntroductionSecondary hyperparathyroidism (SHPT) is a common complication in hemodialysis patients with chronic renal failure uremia. For severe SHPT, parathyroidectomy is effective. Owing to the variability in parathyroid anatomy, surgical parathyroidectomy can be complex and many patients experience recurrent SHPT, which may require repeated surgery. These cases pose significant challenges to surgeons.Case descriptionAn elderly woman with recurrent severe SHPT was admitted to our hospital. Preoperative methoxyisobutylisonitrile (MIBI) examination found a large ectopic parathyroid gland in the superior mediastinum, and she underwent reoperative parathyroidectomy. A large parathyroid gland in the right anterior mediastinum and another parathyroid gland in the left lingual lobe of the thymus were removed. The patient had postoperative hypocalcemia that was successfully corrected with calcium supplementation via femoral vein catheterization. During the 1-year postoperative follow-up, the patient's iPTH was well controlled and her blood calcium was within the normal range.ConclusionWe report a case of parathyroidectomy to remove multifocal ectopic hyperplastic parathyroid tissue in the mediastinum. Preoperative MIBI accurately detected the lesions. Calcium supplementation via femoral vein catheterization successfully corrected postoperative hypocalcemia. Postoperative follow-up for 1 year indicated that the surgery was successful.https://www.frontiersin.org/articles/10.3389/fsurg.2022.921026/fullreoperative parathyroidectomysecondary hyperparathyroidismchronic renal failure (CRF)hemodialysishypocalcemiaIPTH |
| spellingShingle | Yong Lv Qiuyuan Wang Qiuyuan Wang Ling Zhang Qing Zhou Zhiyu Mi Yi Wu Jingning Cheng Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism Frontiers in Surgery reoperative parathyroidectomy secondary hyperparathyroidism chronic renal failure (CRF) hemodialysis hypocalcemia IPTH |
| title | Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism |
| title_full | Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism |
| title_fullStr | Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism |
| title_full_unstemmed | Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism |
| title_short | Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism |
| title_sort | case report reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism |
| topic | reoperative parathyroidectomy secondary hyperparathyroidism chronic renal failure (CRF) hemodialysis hypocalcemia IPTH |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2022.921026/full |
| work_keys_str_mv | AT yonglv casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT qiuyuanwang casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT qiuyuanwang casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT lingzhang casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT qingzhou casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT zhiyumi casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT yiwu casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism AT jingningcheng casereportreoperativeparathyroidectomyforlargeectopichyperplasticparathyroidinthemediastinumofapatientwithrecurrentsecondaryhyperparathyroidism |