Minimally Invasive Interventions Used with the Guidance of SPECT/CT in the Treatment of Mediastinal Parathyroid Adenomas

Locating and removing ectopic parathyroid tissue may result in more than 20% failure. Seven cases which were detected by single photon emission computed tomography/computed tomography (SPECT/CT) imaging with Tc-99m sestamibi and treated with minimally invasive surgical methods were presented. The cases that underwent SPECT/CT due to high parathormone (PTH) level after total/subtotal parathyroidectomy operation, and detected to have mediastinal ectopic parathyroid were included. The success of the surgery was assessed with preoperative and postoperative PTH levels. Video-assisted thoracic surgery (VATS) was performed on five of the cases and video-assisted mediastinoscopy (VAM) was performed on remaining two. The mean age was 52.4±19.0. There were six women and one man. Mediastinal adenomas ranging from 1.5 to 6 cm in size, were successfully treated after single attempt. If the mediastinal ectopic parathyroid adenomas are fully localized before surgery, it can be treated with minimally invasive surgical methods.