We report the case of a 76-year-old patient who had been admitted on several occasions for severe hypercalcemia. Her calcium and PTH levels rose to 18.3mg/dl and 1016.9pg/ml, respectively. Scintigraphy/SPECT and chest CT scan (Fig. 1) revealed a multinodular goiter with intrathoracic component and a right paratracheal mass measuring 5cm×5cm×8cm extending to the middle and posterior mediastinum. Endobronchial ultrasound biopsy showed parathyroid lipoadenoma.
First, total thyroidectomy was performed via a midline Kocher's incision. In the same surgical act, the mediastinal mass was resected by video-assisted thoracoscopy (Fig. 1). After removal of the mass, the PTH blood concentration fell to 300pg/ml, and values normalized in the following days. Histopathology confirmed the diagnosis of parathyroid lipoadenoma.
The patient is currently asymptomatic and disease-free, 7 months after surgery.
Parathyroid lipoadenoma is a rare cause of hyperparathyroidism1 which can go unnoticed. This entity should therefore be borne in mind during the differential diagnosis of mediastinal tumors, and video-assisted thoracoscopy should be considered. Our patient presented a large mass weighing 90.1mg, which was successfully resected by video-assisted thoracoscopy.
Please cite this article as: Triviño A, Varelab J, Ayllón S. Lipoadenoma paratirodeo mediastínico. Arch Bronconeumol. 2020;56:323.
