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. 1981 Jun;193(6):805–809. doi: 10.1097/00000658-198106000-00016

Mediastinal parathyroid tumors: experience with 38 tumors requiring mediastinotomy for removal.

C F Russell, A J Edis, D A Scholz, P F Sheedy, J A van Heerden
PMCID: PMC1345178  PMID: 7247524

Abstract

Most hyperfunctioning parathyroid tumors situated in the mediastinum can be removed by means of a cervical approach. However, a few tumors, because of their location deep in the chest, require mediastinotomy for removal. These tumors are probably derived from parathyroid glands that have developed from the third branchial pouch. Between 1942 and 1980, 38 such tumors were removed at the Mayo Clinic, using a sternum-splitting procedure. With one exception, the patients had undergone previous parathyroid exploration, Almost all of the patients had significant complications of primary hyperparathyroidism (HPT). Thirty-seven patients (97%) were cured after removal of their mediastinal parathyroid tumors, but postoperative chest complications were encountered in eight patients (21%), and eight have permanent hypoparathyroidism. Six patients had selective arteriography, two had selective thyroid venous sampling and parathyroid hormone assay, and 13 had mediastinal computed tomography in an attempt to localize tumors before operation. The anatomic locations of the tumors at operation were variable, but the vast majority (68%) were in or near the thymus.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BAUER W., FEDERMAN D. D. Hyperparathyroidism epitomized: the case of Captain Charles E. Martell. Metabolism. 1962 Jan;11:21–29. [PubMed] [Google Scholar]
  2. BOYD J. D. Development of the thyroid and parathyroid glands and the thymus. Ann R Coll Surg Engl. 1950 Dec;7(6):455–471. [PMC free article] [PubMed] [Google Scholar]
  3. Berry B. E., Carpenter P. C., Fulton R. E., Danielson G. K. Mediastinal hemorrhage from parathyroid adenoma simulating dissecting aneurysm. Arch Surg. 1974 May;108(5):740–741. doi: 10.1001/archsurg.1974.01350290102019. [DOI] [PubMed] [Google Scholar]
  4. Black B. M. Hyperparathyroidism: some aspects of current surgical interest. Am Surg. 1971 Mar;37(3):130–134. [PubMed] [Google Scholar]
  5. Brennan M. F., Brown E. M., Sears H. F., Aurbach G. D. Human parathyroid cryopreservation: in vitro testing of function by parathyroid hormone release. Ann Surg. 1978 Jan;187(1):87–90. doi: 10.1097/00000658-197801000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Cope O. SURGERY OF HYPERPARATHYROIDISM: THE OCCURRENCE OF PARATHYROIDS IN THE ANTERIOR MEDIASTINUM AND THE DIVISION OF THE OPERATION INTO TWO STAGES. Ann Surg. 1941 Oct;114(4):706–733. doi: 10.1097/00000658-194110000-00016. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Edis A. J., Linos D. A., Kao P. C. Parathyroid autotransplantation at the time of reoperation for persistent hyperparathyroidism. Surgery. 1980 Oct;88(4):588–593. [PubMed] [Google Scholar]
  8. Edis A. J., Sheedy P. F., Beahrs O. H., van Heerden J. A. Results of reoperation for hyperparathyroidism, with evaluation of preoperative localization studies. Surgery. 1978 Sep;84(3):384–393. [PubMed] [Google Scholar]
  9. Edis A. J., van Heerden J. A., Scholz D. A. Results of subtotal parathyroidectomy for primary chief cell hyperplasia. Surgery. 1979 Sep;86(3):462–469. [PubMed] [Google Scholar]
  10. Mishkin M. M., Baum S., Di Chiro G. Emergency treatment of angiography-induced paraplegia and tetraplegia. N Engl J Med. 1973 May 31;288(22):1184–1185. doi: 10.1056/NEJM197305312882213. [DOI] [PubMed] [Google Scholar]
  11. Nathaniels E. K., Nathaniels A. M., Wang C. A. Mediastinal parathyroid tumors: a clinical and pathological study of 84 cases. Ann Surg. 1970 Feb;171(2):165–170. doi: 10.1097/00000658-197002000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. SELDINGER S. I. Localization of parathyroid adenomata by arteriography. Acta radiol. 1954 Nov;42(5):353–366. doi: 10.3109/00016925409175876. [DOI] [PubMed] [Google Scholar]
  13. Scholz D. A., Purnell D. C., Woolner L. B., Clagett O. T. Mediastinal hyperfunctioning parathyroid tumors: review of 14 cases. Ann Surg. 1973 Aug;178(2):173–178. doi: 10.1097/00000658-197308000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Wang C. A. Parathyroid re-exploration. A clinical and pathological study of 112 cases. Ann Surg. 1977 Aug;186(2):140–145. doi: 10.1097/00000658-197708000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wells S. A., Jr, Ellis G. J., Gunnells J. C., Schneider A. B., Sherwood L. M. Parathyroid autotransplantation in primary parathyroid hyperplasia. N Engl J Med. 1976 Jul 8;295(2):57–62. doi: 10.1056/NEJM197607082950201. [DOI] [PubMed] [Google Scholar]

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