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Radio-guided thoracoscopic surgery with 99mTc-methoxy-isobutylisonitrile for treating an ectopic mediastinal parathyroid adenoma in an adolescent girl

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Abstract

Here we report the case of a 17-year-old girl treated for an ectopic mediastinal parathyroid adenoma using 99mTc-methoxy-isobutyl-isonitrile (MIBI) and radio-guided thoracoscopic surgery. Her serum calcium and intact parathyroid hormone levels were elevated, and an anterior mediastinal tumor was noted on her chest computed tomography scan. At 2 h before surgery, the patient was given an injection of 370 MBq of 99mTc-MIBI. Because it was not possible visually to distinguish the tumor from the mature thymic tissue in which it was embedded, a search for the tumor was carried out using a gamma probe under thoracoscopy. Thereafter, the left thymus, including the radioactivity-positive tumor, was resected. We suggest that radio-guided thoracoscopic surgery with 99mTc-MIBI is an excellent procedure for treating ectopic mediastinal parathyroid adenomas embedded in the mature thymus of adolescents and young adults. This approach could be especially useful for young female patients, given its cosmetic advantage.

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References

  1. Kuriloff DB, Sanborn KV. Rapid intraoperative localization of parathyroid glands utilizing methylene blue infusion. Otolaryngol Head Neck Surg 2004;131:616–622.

    Article  PubMed  Google Scholar 

  2. Patel AS, Singh-Ranger D, Lowery KA, Crinnion JN. Adverse neurologic effect of methylene blue used during parathyroidectomy. Head Neck 2006;28:567–568.

    Article  PubMed  Google Scholar 

  3. Majithia A, Stearns MP. Methylene blue toxicity following infusion to localize parathyroid adenoma. J Laryngol Otol 2006;120:138–140.

    Article  CAS  PubMed  Google Scholar 

  4. Khan MA, North AP, Chadwick DR. Prolonged postoperative altered mental status after methylene blue infusion during parathyroidectomy: a case report and review of the literature. Ann R Coll Surg Engl 2007;89:W9–11.

    Article  CAS  PubMed  Google Scholar 

  5. Hsu SC, Levine MA. Primary hyperparathyroidism in children and adolescents: the Johns Hopkins Children’s Center experience 1984–2001. J Bone Miner Res 2002;17(suppl 2):N44–50.

    PubMed  Google Scholar 

  6. Nishino M, Ashiku SK, Kocher ON, Thurer RL, Boiselle PM, Hatabu H. The thymus: a comprehensive review. Radiographics 2006;26:335–348.

    Article  PubMed  Google Scholar 

  7. Kartha SS, Chacko CE, Bumpous JM, Fleming M, Lentsch EJ, Flynn MB. Toxic metabolic encephalopathy after parathyroidectomy with methylene blue localization. Otolaryngol Head Neck Surg 2006;135:765–768.

    Article  PubMed  Google Scholar 

  8. Vutskits L, Briner A, Klauser P, Gascon E, Dayer AG, Kiss JZ, et al. Adverse effects of methylene blue on the central nervous system. Anesthesiology 2008;108:684–692.

    Article  CAS  PubMed  Google Scholar 

  9. Casara D, Rubello D, Pelizzo MR, Shapiro B. Clinical role of 99mTcO4/MIBI scan, ultrasound and intra-operative gamma probe in the performance of unilateral and minimally invasive surgery in primary hyperparathyroidism. Eur J Nucl Med 2001; 28:1351–1359.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Thoracic Surgery, Department of Surgery, Akita University School of Medicine, 1-1-1 Hondo, Akita, 010-8543, Japan

    Yoshihiro Minamiya, Hajime Saito, Manabu Ito, Satoru Motoyama, Yoshihisa Katayose & Jun-ichi Ogawa

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  1. Yoshihiro Minamiya
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  2. Hajime Saito
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  3. Manabu Ito
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  4. Satoru Motoyama
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  5. Yoshihisa Katayose
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  6. Jun-ichi Ogawa
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Correspondence to Yoshihiro Minamiya.

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Minamiya, Y., Saito, H., Ito, M. et al. Radio-guided thoracoscopic surgery with 99mTc-methoxy-isobutylisonitrile for treating an ectopic mediastinal parathyroid adenoma in an adolescent girl. Gen Thorac Cardiovasc Surg 57, 657–659 (2009). https://doi.org/10.1007/s11748-009-0458-5

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  • DOI: https://doi.org/10.1007/s11748-009-0458-5

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