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Preoperative Localization of Mediastinal Parathyroid Adenoma with Intra-arterial Methylene Blue

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Abstract

Ectopic parathyroid is found in 16% of patients with hyperparathyroidism. 2% of ectopic parathyroid adenomas are not accessible to standard cervical excision. In such cases, video-assisted thoracoscopic resection is the recommended definitive treatment. We present a case of mediastinal parathyroid adenoma localized preoperatively by injecting methylene blue within a branch of the internal mammary artery that is supplying the adenoma. Intra-arterial methylene blue injection facilitated visualization and resection of the adenoma. The preoperative intra-arterial infusion of methylene blue appears to be an effective and safe method for localization of ectopic mediastinal parathyroid adenomas and allows rapid identification during thoracoscopic resection.

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Authors and Affiliations

  1. Department of Diagnostic Radiology, American University of Beirut Medical Center, Beirut, Lebanon

    Rida Salman, Mikhael G. Sebaaly & Aghiad Al-Kutoubi

  2. Department of General Surgery, American University of Beirut Medical Center, Beirut, Lebanon

    Mohammad Rachad Wehbe, Pierre Sfeir & Mohamad Khalife

Authors
  1. Rida Salman
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  2. Mikhael G. Sebaaly
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  3. Mohammad Rachad Wehbe
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  4. Pierre Sfeir
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  5. Mohamad Khalife
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  6. Aghiad Al-Kutoubi
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Corresponding author

Correspondence to Aghiad Al-Kutoubi.

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The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in this case were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments.

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Informed consent was obtained from all individual participants included in the study.

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Salman, R., Sebaaly, M.G., Wehbe, M.R. et al. Preoperative Localization of Mediastinal Parathyroid Adenoma with Intra-arterial Methylene Blue. Cardiovasc Intervent Radiol 40, 953–956 (2017). https://doi.org/10.1007/s00270-017-1578-4

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  • DOI: https://doi.org/10.1007/s00270-017-1578-4

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