PP 117. EBUS-TBNA to Diagnose Large Posterior Mediastinal Parathyroid Adenoma
S. Buderi, S. Hesham, M. Thomas, M. Shackcloth
17:42 - 17:48h
at Margrit Room
Categories: Poster Session , Thoracic Surgery
Session: Poster II (P3) - Emergency / Thoracic Surgery
Background
A 65 year-old female patient was referred with hypercalcemia and found to have a 4cm retrotracheal mass on computed tomography. The patient also suffered from neurofibromatosis and a recently diagnosed gastric mass. Tc99sestamibi scintigraphy revealed an area of intense uptake in the right upper mediastinum. Endo-bronchial ultrasound-guided trans-bronchial needle aspiration was used to confirm the diagnosis of parathyroid adenoma and thoracoscopic resection was subsequently performed. Endo-bronchial ultrasound-guided trans-bronchial needle aspiration biopsy can be a helpful diagnostic tool to confirm diagnosis of mediastinal parathyroid masses in patients with atypical or complex clinical presentations.
Material and Methods
A 65-year-old female patient was referred for surgical excision of a mediastinal parathyroid adenoma. The diagnosis of hyperparathyroidism was established previously with elevated calcium level of 3.68 mmol/L, normal parathyroid hormone levels and a well-defined retro-tracheal mass measuring (4cm x 3cm x 2cm) on computed tomography. Tc99sestamibi scintigraphy showed focal intense uptake in the upper right side of the mediastinum. The patient's medical history also included a diagnosis of type 1 neurofibromatosis and a recent upper gastro-intestinal bleed investigated by endoscopy and biopsy of an antral gastric mass that proved to be benign.
Result
Further characterization of the mass was deemed necessary due to its size to exclude a parathyroid carcinoma, and ultrasound-guided trans-bronchial needle aspiration (EBUS-TBNA) was performed as a means of obtaining a histopathological diagnosis.
Conclusion
The results of biopsy were consistent with a parathyroid adenoma. Patient was operated with good results.
