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Ann Thorac Surg 2001;72:1758-1760
© 2001 The Society of Thoracic Surgeons

Case report

Intraoperative radioguided thoracoscopic removal of ectopic parathyroid adenoma

Michael C. Ott, MSca, Richard A. Malthaner, MD*a, Robert Reid, MDb

a Division of Thoracic Surgery, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
b Department of Nuclear Medicine, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada

Accepted for publication January 19, 2001.

* Address reprint requests to Dr Malthaner, Division of Thoracic Surgery, London Health Sciences Centre, 375 South St, N345, London, Ontario, Canada N6A 4G5
e-mail: richard.malthaner{at}lhsc.on.ca

Twenty-five percent of primary hyperparathyroidism is caused by ectopic mediastinal parathyroid glands, with 2% of these not accessible to standard cervical surgical approaches. Advancement in video-assisted thoracoscopic surgical techniques has decreased the need for sternotomy to successfully remove these ectopic glands. The thoracoscopic approach, however, is limited by the surgeon’s inability to always accurately visualize ectopic glands. Intraoperative radionuclide-guided dissection, using a thoracoscopic approach, provides a novel adjunct to the removal of occult ectopic parathyroid glands. We report a case of an occult ectopic parathyroid adenoma removed thoracoscopically using an intraoperative handheld gamma probe.




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