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Acta Médica Costarricense

On-line version ISSN 0001-6002Print version ISSN 0001-6012


SOLIS-TORRES, Jeffry  and  MORA-SEGURA, Esteban. Primary hyperparathyroidism caused by a mediastinal parathyroid adenoma . Acta méd. costarric [online]. 2015, vol.57, n.2, pp.86-87. ISSN 0001-6002.

Primary hyperparathyroidism results from an increased secretion of parathyroid hormone (PTH) into the blood stream, its most common etiology is an adenoma of the parathyroid gland, which causes hypercalcaemia. Classically a patient presents elevated serum calcium and PTH levels, associated with imaging studies. The treatment consists of surgical excision with high rates of success. We present the case of a 63-year old hypertensive female, with a history of loss of appetite and general weakness for the last year and a half. Laboratory exams showed hypercalcaemia and an elevated PTH. A Tc 99 scan revealed an 18 mm nodule, located 2 cm caudal to the right thyroidal lobe. A neck exploration was performed but an adenoma could not be located, so a median sternotomy was then requested and a superior mediastinal adenoma, posterior to the right brachiocephalic vein was found and resected. Laboratory controls done 24-hour later revealed normal PTH and serum calcium levels and the patient was discharged.

Keywords : hyperparathyroidism; hypercalcemia; parathyroid hormone.

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