Surgical Management of Mediastinal Ectopic Parathyroids
Abstract
1. Introduction
2. Preoperative Identification Strategies
2.1. Computed Tomography
2.2. Tc-99m Sestamibi Scintigraphy
2.3. Single Photon Emission Computed Tomography
2.4. Neck Ultrasound
2.5. Magnetic Resonance Imaging (MRI)
2.6. Positron Emission Tomography (PET/CT)
2.7. Pre-Operative Diagnosis
3. Surgical Treatment
3.1. Open Approaches
3.2. Minimally Invasive Approaches
3.3. Intraoperative Evaluation
- •
- Confirmation of the removal of all hyperfunctioning parathyroid tissue without visualizing all glands
- •
- Identification of inadequate PTH decline indicating the presence of additional hyperfunctioning glands
- •
- Determination of the need for further exploration
- •
- Differentiation between parathyroid and non-parathyroid tissues
- •
- Bilateral internal jugular vein sampling to lateralize hyperfunctioning glands [60]
4. Surgical Outcomes
Redo Surgery
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
APW | Aortopulmonary Window |
BNE | Bilateral Neck Exploration |
CT | Computed Tomography |
DOCI | Dynamic Optical Contrast Imaging |
EANM | European Association of Nuclear Medicine |
ESRD | End-Stage Renal Disease |
FNA | Fine-Needle Aspiration |
ICG | Indocyanine Green |
ioPTH | Intraoperative Parathyroid Hormone |
IVC | Inferior Vena Cava |
LSCI | Laser Speckle Contrast Imaging |
MEN1 | Multiple Endocrine Neoplasia Type 1 |
MIS | Minimally Invasive Surgery |
MRI | Magnetic Resonance Imaging |
MIP | Minimally Invasive Parathyroidectomy |
OCT | Optical Coherence Tomography |
PET/CT | Positron Emission Tomography/Computed Tomography |
PHPT | Primary Hyperparathyroidism |
PTH | Parathyroid Hormone |
PTG | Parathyroid Gland |
R/L | Right/Left |
RATS | Robot-Assisted Thoracoscopic Surgery |
SCa | Serum Calcium |
SHPT | Secondary Hyperparathyroidism |
SPECT | Single Photon Emission Computed Tomography |
SVS | Selective Venous Sampling |
99mTc | Technetium-99m |
THPT | Tertiary Hyperparathyroidism |
US | Ultrasound/Ultrasonography |
VATS | Video-Assisted Thoracoscopic Surgery |
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Rabazzi, G.; Elia, G.; Aprile, V.; Korasidis, S.; Mastromarino, M.G.; Bacchin, D.; Lenzini, A.; Ambrogi, M.C.; Alì, G.; Cetani, F.; et al. Surgical Management of Mediastinal Ectopic Parathyroids. J. Pers. Med. 2025, 15, 276. https://doi.org/10.3390/jpm15070276
Rabazzi G, Elia G, Aprile V, Korasidis S, Mastromarino MG, Bacchin D, Lenzini A, Ambrogi MC, Alì G, Cetani F, et al. Surgical Management of Mediastinal Ectopic Parathyroids. Journal of Personalized Medicine. 2025; 15(7):276. https://doi.org/10.3390/jpm15070276
Chicago/Turabian StyleRabazzi, Giacomo, Gianmarco Elia, Vittorio Aprile, Stylianos Korasidis, Maria Giovanna Mastromarino, Diana Bacchin, Alessandra Lenzini, Marcello Carlo Ambrogi, Greta Alì, Filomena Cetani, and et al. 2025. "Surgical Management of Mediastinal Ectopic Parathyroids" Journal of Personalized Medicine 15, no. 7: 276. https://doi.org/10.3390/jpm15070276
APA StyleRabazzi, G., Elia, G., Aprile, V., Korasidis, S., Mastromarino, M. G., Bacchin, D., Lenzini, A., Ambrogi, M. C., Alì, G., Cetani, F., Materazzi, G., & Lucchi, M. (2025). Surgical Management of Mediastinal Ectopic Parathyroids. Journal of Personalized Medicine, 15(7), 276. https://doi.org/10.3390/jpm15070276