胸腔鏡下に摘出した高齢者縦隔内機能性副甲状腺腺腫の1例

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  • THORACOSCOPIC REMOVAL FOR MEDIASTINAL PARATHYROID ADENOMA WITH HYPERPARATHYROIDISM IN AN OCTOGENARIAN-A CASE REPORT-

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An 83-year-old woman with dementia was found to have hypercalcemia when she was treated for bone fracture. The high-sensitivity parathormone (PTH) was abnormally high, 25300pg/ml, and 99mTc-methoxy-isobutyl-isonitrile scintigram showed abnormal uptake at the inferior left sternoclavicular joint. Chest CT scan with contrast enhancement showed two mass lesions in the anterior mediastinum, at the anterior portion to the confluence of brachiocephalic veins and at the anterior portion to the aortic arch, respectively. Because her hospitalization had to be maintained without correction of hypercal-cemia, a thoracoscopic removal of the tumors was carried out. Right thoracoscopic approach was made and the tumor was removed from the left lobe of the thymus. The pathohistological diagnosis was parathyroid adenoma. The postoperative course was uneventful and her serum levels of Ca and PTH decreased remarkably. Additionally, her psychotic state and behavior were improved after the surgery and she was discharged from the hospital.<br> Thoracoscopic removal for mediastinal parathyroid adenoma with hyperparathyroidism is safe and effective in patients of advanced age.

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