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Parathyroid adenoma - ectopic

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Recurrent renal stone disease

Patient Data

Age: 45 years
Gender: Female
x-ray

Bilateral renal stones.

x-ray

A chest radiograph was performed prior to percutaneous nephrolithotomy (PCNL). 

Right sided mediastinal mass, which demonstrates the hilum overlay sign.

Nuclear medicine

A MIBI scan was undertaken to assess for a parathyroid adenoma. 

Avid tracer uptake in the mediastinal mass visualized on plain chest radiograph, confirms it represents an ectopic parathyroid adenoma.

Case Discussion

In a small number of cases, recurrent renal stone diseases (nephrolithiasis) is due to an underlying metabolic condition. This includes primary hyperparathyroidism due to a parathyroid adenoma. Rarely these occur in an ectopic location, typically the mediastinum, rather than in the neck.

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