A CASE OF GIANT PARATHYROID ADENOMA IN MEDIASTIUM

We report a case of giant parathyroid adenoma in mediastium. A 54-year-old female woman was admitted to the hospital because of hoarseness, lumbago and left patella fracture for which she was not able to walk. Blood Ca level was 17.4mg/ml and c-PTH was 46.96ng/ml. Blood ALP level and BGP were also high. X-ray film of the head showed salt and pepper appearance. CT and MRI films of the neck and chest showed a solid and smooth tumor located in the right upper mediastium to the neck. The patient was diagnosed as having primary hyperparathyroidism due to the parathyroid tumor. The tumor was excised from the neck wound without mediastinotomy. It was a parathyroid tumor, 32g in weight and 7.0×5.0×1.5cm in size, located in the site which coincided with the location shown in the CT and MRI films. Pathologically it was diagnosed as parathyroid adenoma. After the operation, hoarseness and lumbago disappeared and her general condition was getting better. Blood Ca level and PTH fell to the normal range. Blood ALP level and BGP level fell to the normal range. Therefore, she was able to walk after rihabilitation therapy.