{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:24:56Z","timestamp":1768281896111,"version":"3.49.0"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T00:00:00Z","timestamp":1660953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Cardiothorac Surg"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Primary hyperparathyroidism is a disease caused by the secretion of excess parathyroid hormone (PTH) owing to the enlargement of the parathyroid gland. Ectopic parathyroid glands exist in the mediastinum in approximately 1\u20132% of cases, which is relatively rare. Intraoperative monitoring of serum PTH level is important to assess whether the source of hyperparathyroidism has been eliminated.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 53-year-old asymptomatic woman was diagnosed with ectopic mediastinal parathyroid adenoma. A three-port robotic partial resection of the thymus containing the tumor was attempted, but bleeding from a swollen pericardial diaphragmatic vein led to the addition of an assist port along the way. The PTH level was measured intraoperatively. After confirming that the 15-min PTH level after removal of the tumor was less than 50% of the baseline value, the operation was completed. The tumor was positive for PTH and was diagnosed as an ectopic mediastinal parathyroid adenoma. Some small ectopic parathyroid gland tissues were observed in other parts of the thymic tissue. Serum calcium and PTH levels decreased and normalized.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We report the usefulness of robotic resection for ectopic mediastinal parathyroid adenoma with PTH monitoring. However, histopathologically, small parathyroid gland tissues may remain in the surrounding thymus. Hence, we believe that a strict follow-up is required for parathyroid function in the future.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s13019-022-01935-2","type":"journal-article","created":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T16:02:42Z","timestamp":1661011362000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Robotic resection of ectopic mediastinal parathyroid adenoma with intraoperative parathyroid hormone monitoring: a case report"],"prefix":"10.1186","volume":"17","author":[{"given":"Yoshihito","family":"Iijima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahito","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Iwai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aika","family":"Yamagata","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiro","family":"Kishimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nozomu","family":"Motono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaka","family":"Uramoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,8,20]]},"reference":[{"key":"1935_CR1","first-page":"1915","volume-title":"Shields\u2019 general thoracic surgery","author":"DJ Boffa","year":"2019","unstructured":"Boffa DJ. Mediastinal parathyroids. In: Locicero J, Feins RH, Colson YL, Rocco G, editors. Shields\u2019 general thoracic surgery. 8th ed. Philadelphia: Walters Kluwer; 2019. p. 1915\u201320.","edition":"8"},{"key":"1935_CR2","doi-asserted-by":"publisher","first-page":"628","DOI":"10.2995\/jacsurg.34.628","volume":"34","author":"N Kawamoto","year":"2020","unstructured":"Kawamoto N, Inokawa H, Okita R, Furukawa M, Hayashi M, Okabe K. A case of prolonged hypocalcemia after resection of an ectopic mediastinal parathyroid adenoma. Jpn J Chest Surg. 2020;34:628\u201334. https:\/\/doi.org\/10.2995\/jacsurg.34.628 (in Japanese with English abstract).","journal-title":"Jpn J Chest Surg."},{"key":"1935_CR3","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1007\/s00268-007-9303-0","volume":"32","author":"PF Alesina","year":"2008","unstructured":"Alesina PF, Moka D, Mahlstedt J, Walz MK. Thoracoscopic removal of mediastinal hyperfunctioning parathyroid glands: personal experience and review of the literature. World J Surg. 2008;32:224\u201331. https:\/\/doi.org\/10.1007\/s00268-007-9303-0.","journal-title":"World J Surg"},{"key":"1935_CR4","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1097\/SLA.0b013e3181c1cfb0","volume":"251","author":"B Randone","year":"2010","unstructured":"Randone B, Costi R, Scatton O, Fulla Y, Bertagna X, Soubrane O, et al. Thoracoscopic removal of mediastinal parathyroid glands: a critical appraisal of an emerging technique. Ann Surg. 2010;251:717\u201321. https:\/\/doi.org\/10.1097\/SLA.0b013e3181c1cfb0.","journal-title":"Ann Surg"},{"key":"1935_CR5","doi-asserted-by":"publisher","first-page":"1662","DOI":"10.1093\/clinchem\/46.10.1662","volume":"46","author":"LJ Sokoll","year":"2000","unstructured":"Sokoll LJ, Drew H, Udelsman R. Intraoperative parathyroid hormone analysis: a study of 200 consecutive cases. Clin Chem. 2000;46:1662\u20138. https:\/\/doi.org\/10.1093\/clinchem\/46.10.1662.","journal-title":"Clin Chem"},{"key":"1935_CR6","doi-asserted-by":"publisher","first-page":"3602","DOI":"10.1002\/cncr.28891","volume":"120","author":"GG Callender","year":"2014","unstructured":"Callender GG, Udelsman R. Surgery for primary hyperparathyroidism. Cancer. 2014;120:3602\u201316. https:\/\/doi.org\/10.1002\/cncr.28891.","journal-title":"Cancer"},{"key":"1935_CR7","doi-asserted-by":"publisher","first-page":"1750","DOI":"10.1016\/j.athoracsur.2010.02.076","volume":"89","author":"D Sagan","year":"2010","unstructured":"Sagan D, Go\u017adziuk K. Surgical treatment of mediastinal parathyroid adenoma: rationale for intraoperative parathyroid hormone monitoring. Ann Thorac Surg. 2010;89:1750\u20135. https:\/\/doi.org\/10.1016\/j.athoracsur.2010.02.076.","journal-title":"Ann Thorac Surg"},{"key":"1935_CR8","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1007\/s11701-016-0637-1","volume":"11","author":"AF Ward","year":"2017","unstructured":"Ward AF, Lee T, Ogilvie JB, Patel KN, Hiotis K, Bizekis C, et al. Robot-assisted complete thymectomy for mediastinal ectopic parathyroid adenomas in primary hyperparathyroidism. J Robot Surg. 2017;11:163\u20139. https:\/\/doi.org\/10.1007\/s11701-016-0637-1.","journal-title":"J Robot Surg"},{"key":"1935_CR9","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1097\/IMI.0000000000000108","volume":"9","author":"P Sridhar","year":"2014","unstructured":"Sridhar P, Steenkamp DW, Lee SL, Ebright MI, Litle VR, Fernendo HC. Mediastinal parathyroid adenoma with osteitis fibrosis cystica: robot-assisted thoracic surgical resection. Innovations (Phila). 2014;9:445\u20137. https:\/\/doi.org\/10.1097\/IMI.0000000000000108.","journal-title":"Innovations (Phila)"},{"key":"1935_CR10","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1177\/0218492309354218","volume":"18","author":"AP Chan","year":"2010","unstructured":"Chan AP, Wan IY, Wong RH, Hsin MK, Underwood MJ. Robot-assisted excision of ectopic mediastinal parathyroid adenoma. Asian Cardiovasc Thorac Ann. 2010;18:65\u20137. https:\/\/doi.org\/10.1177\/0218492309354218.","journal-title":"Asian Cardiovasc Thorac Ann"},{"key":"1935_CR11","doi-asserted-by":"publisher","first-page":"1561","DOI":"10.1089\/lap.2019.0266","volume":"29","author":"BB Scott","year":"2019","unstructured":"Scott BB, Maxfield MW, Hamaguchi R, Wilson JL, Kent MS, Gangadharan SP. Robot-assisted thoracoscopic mediastinal parathyroidectomy: a single surgeon case series. J Laparoendosc Adv Surg Tech A. 2019;29:1561\u20134. https:\/\/doi.org\/10.1089\/lap.2019.0266.","journal-title":"J Laparoendosc Adv Surg Tech A"},{"key":"1935_CR12","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1007\/s40137-014-0046-1","volume":"2","author":"DM Elfenbein","year":"2014","unstructured":"Elfenbein DM, Schneider DF. Intraoperative parathyroid hormone testing: Who should be the target? Curr Surg Rep. 2014;2:46. https:\/\/doi.org\/10.1007\/s40137-014-0046-1.","journal-title":"Curr Surg Rep"},{"key":"1935_CR13","doi-asserted-by":"publisher","first-page":"691","DOI":"10.1097\/SLA.0b013e3181f698df","volume":"252","author":"H Chen","year":"2010","unstructured":"Chen H, Wang TS, Yen TW, Doffek K, Krzywda E, Schaefer S, et al. Operative failures after parathyroidectomy for hyperparathyroidism: the influence of surgical volume. Ann Surg. 2010;252:691\u20135. https:\/\/doi.org\/10.1097\/SLA.0b013e3181f698df.","journal-title":"Ann Surg"},{"key":"1935_CR14","doi-asserted-by":"publisher","DOI":"10.4414\/smw.2019.20160","volume":"149","author":"L Steffen","year":"2019","unstructured":"Steffen L, Moffa G, M\u00fcller PC, Oertli D. Secondary hyperparathyroidism: recurrence after total parathyroidectomy with autotransplantation. Swiss Med Wkly. 2019;149: w20160. https:\/\/doi.org\/10.4414\/smw.2019.20160.","journal-title":"Swiss Med Wkly"},{"key":"1935_CR15","first-page":"456","volume":"113","author":"MS Sokol","year":"1993","unstructured":"Sokol MS, Kavolius J, Schaaf M, D\u2019Avis J. Recurrent hyperparathyroidism from benign neoplastic seeding: a review with recommendations for management. Surgery. 1993;113:456\u201361.","journal-title":"Surgery"},{"key":"1935_CR16","doi-asserted-by":"publisher","first-page":"1758","DOI":"10.1016\/s0003-4975(01)02652-2","volume":"72","author":"MC Ott","year":"2001","unstructured":"Ott MC, Malthaner RA, Reid R. Intraoperative radioguided thoracoscopic removal of ectopic parathyroid adenoma. Ann Thorac Surg. 2001;72:1758\u201360. https:\/\/doi.org\/10.1016\/s0003-4975(01)02652-2.","journal-title":"Ann Thorac Surg"},{"key":"1935_CR17","doi-asserted-by":"publisher","first-page":"67","DOI":"10.5761\/atcs.cr.12.01960","volume":"20","author":"ST Liman","year":"2014","unstructured":"Liman ST, Topcu S, Dervisoglu E, Gorur GD, Elicora A, Burc K, et al. Excision of ectopic mediastinal parathyroid adenoma via parasternal videomediastinoscopy. Ann Thorac Cardiovasc Surg. 2014;20:67\u20139. https:\/\/doi.org\/10.5761\/atcs.cr.12.01960.","journal-title":"Ann Thorac Cardiovasc Surg"},{"key":"1935_CR18","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1136\/bmj.3.5776.680","volume":"3","author":"NE Dudley","year":"1971","unstructured":"Dudley NE. Methylene blue for rapid identification of parathyroids. Br Med J. 1971;3:680\u20131. https:\/\/doi.org\/10.1136\/bmj.3.5776.680.","journal-title":"Br Med J"},{"key":"1935_CR19","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1007\/BF02471538","volume":"18","author":"S Kobayashi","year":"1988","unstructured":"Kobayashi S, Miyakawa M, Sugenoya A, Senga O, Kaneko G, Yokozawa T, et al. An evaluation of the intraoperative staining technique using methylene blue for the detection of hyperplastic parathyroid glands. Jpn J Surg. 1988;18:729\u201331. https:\/\/doi.org\/10.1007\/BF02471538.","journal-title":"Jpn J Surg"},{"key":"1935_CR20","doi-asserted-by":"publisher","first-page":"340","DOI":"10.1002\/hed.25451","volume":"41","author":"J van den Bos","year":"2019","unstructured":"van den Bos J, van Kooten L, Engelen SME, Lubbers T, Stassen LPS, Bouvy ND. Feasibility of indocyanine green fluorescence imaging for intraoperative identification of parathyroid glands during thyroid surgery. Head Neck. 2019;41:340\u20138. https:\/\/doi.org\/10.1002\/hed.25451.","journal-title":"Head Neck"},{"key":"1935_CR21","doi-asserted-by":"publisher","first-page":"92","DOI":"10.2995\/jacsurg.30.92","volume":"30","author":"Y Iimura","year":"2016","unstructured":"Iimura Y, Hasegawa N, Aragaki M, Kaga K. Thoracoscopic surgery using near infrared spectroscopy for ectopic parathyroid adenoma detected with gestational hypertension: a case report. Jpn J Chest Surg. 2016;30:92\u20135. https:\/\/doi.org\/10.2995\/jacsurg.30.92 (in Japanese with English abstract).","journal-title":"Jpn J Chest Surg."}],"container-title":["Journal of Cardiothoracic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-022-01935-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13019-022-01935-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13019-022-01935-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,20]],"date-time":"2022-08-20T16:02:57Z","timestamp":1661011377000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiothoracicsurgery.biomedcentral.com\/articles\/10.1186\/s13019-022-01935-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,20]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1935"],"URL":"https:\/\/doi.org\/10.1186\/s13019-022-01935-2","relation":{},"ISSN":["1749-8090"],"issn-type":[{"value":"1749-8090","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,20]]},"assertion":[{"value":"2 April 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 August 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this report and its accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"195"}}