{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T05:52:21Z","timestamp":1788587541390,"version":"build-2803163510"},"reference-count":9,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T00:00:00Z","timestamp":1687305600000},"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":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Hyperparathyroidism in patients with multiple endocrine neoplasia 1 is attributed to the excessive secretion of parathyroid hormone (PTH) from multiple parathyroid glands. This can be successfully treated through complete resection of the parathyroid glands; however, subsequent surgery is often required because of the presence of supernumerary or ectopic parathyroid glands. Therefore, identifying the locations of all functional glands is crucial for precise resection. Here, we report a case of ectopic mediastinal parathyroid adenoma that was successfully resected using robot-assisted thoracoscopic surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 53-year-old woman underwent a total parathyroidectomy with autotransplantation for multiple endocrine neoplasia 1-associated primary hyperparathyroidism. The patient previously underwent laparoscopic distal pancreatectomy for a pancreatic neuroendocrine tumor. She also presented with a mediastinal tumor and nonfunctional pituitary adenoma that could be followed up. Blood tests before total parathyroidectomy showed high levels of intact PTH (183\u00a0pg\/mL) and calcium (Ca; 10.3\u00a0mg\/dL); however, postoperative blood tests still revealed high levels of intact PTH (103\u00a0pg\/mL) and Ca (11.4\u00a0mg\/dL). Computed tomography and magnetic resonance imaging revealed a 45-mm-sized mass in the right upper mediastinum as a well-defined solid and cystic lesion, whereas <jats:sup>99m<\/jats:sup>Tc-methoxyisobutylisonitrile scintigraphy indicated a strong accumulation of tracers, suggesting an ectopic lesion in the mediastinum. Persistent hyperparathyroidism after total parathyroidectomy via neck incision was attributed to an ectopic parathyroid tumor in the mediastinum. Thus, we decided to resect the tumor using robot-assisted thoracoscopic surgery to perform the procedure gently and carefully. During surgery, a mediastinal tumor was identified as it was detected radiographically. Because it did not invade the surrounding tissues, it could be completely resected without injuring the capsule. The patient was discharged without complications. Postoperatively, Ca and intact PTH levels decreased back to normal. The final pathological diagnosis confirmed that the mass was an ectopic mediastinal parathyroid adenoma.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Minimally invasive surgical resection of a remnant ectopic lesion was successfully performed in a patient with multiple endocrine neoplasia 1 using robot-assisted thoracoscopic surgery.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-023-01694-9","type":"journal-article","created":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T12:02:59Z","timestamp":1687348979000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Robotic resection of ectopic mediastinal parathyroid adenoma in multiple endocrine neoplasia 1"],"prefix":"10.1186","volume":"9","author":[{"given":"Yuko","family":"Ohara","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuka","family":"Kadomatsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyone","family":"Kikumori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toyofumi F.","family":"Chen-Yoshikawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,6,21]]},"reference":[{"key":"1694_CR1","first-page":"161","volume":"82","author":"TF Chen-Yoshikawa","year":"2020","unstructured":"Chen-Yoshikawa TF, Fukui T, Nakamura S, Ito T, Kadomatsu Y, Tsubouchi H, et al. Current trends in thoracic surgery. Nagoya J Med Sci. 2020;82:161\u201374.","journal-title":"Nagoya J Med Sci"},{"key":"1694_CR2","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.","journal-title":"World J Surg"},{"key":"1694_CR3","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.","journal-title":"Ann Surg"},{"key":"1694_CR4","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1186\/s13019-022-01935-2","volume":"17","author":"Y Iijima","year":"2022","unstructured":"Iijima Y, Ishikawa M, Iwai S, Yamagata A, Kishimoto K, Motono N, et al. Robotic resection of ectopic mediastinal parathyoid adenoma with intraoperative parathyroid hormone monitoring: a case report. J Cardiothorac Surg. 2022;17:195.","journal-title":"J Cardiothorac Surg"},{"key":"1694_CR5","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-assited complete thymectomy for mediastinal ectopic parathyroid adenomas in primary hyperparathyroidism. J Robotic Surg. 2017;11:163\u20139.","journal-title":"J Robotic Surg"},{"key":"1694_CR6","doi-asserted-by":"publisher","first-page":"1853","DOI":"10.1016\/j.athoracsur.2021.05.090","volume":"113","author":"CE Alvarado","year":"2022","unstructured":"Alvarado CE, Worrell SG, Bachman KC, Jiang B, Janko M, Gray KE, et al. Robotic approach has improved outcomes for minimally invasive resection of mediastinal tumors. Ann Thorac Surg. 2022;113:1853\u20138.","journal-title":"Ann Thorac Surg"},{"key":"1694_CR7","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":"1694_CR8","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":"1694_CR9","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.","journal-title":"Cancer"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-023-01694-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-023-01694-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-023-01694-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,21]],"date-time":"2023-06-21T12:03:21Z","timestamp":1687349001000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-023-01694-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,21]]},"references-count":9,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1694"],"URL":"https:\/\/doi.org\/10.1186\/s40792-023-01694-9","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,6,21]]},"assertion":[{"value":"13 April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 June 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2023","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 Case Report and any accompanying images. A copy of the written consent form is available for review by the Editor-in-Chief of this journal.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"All authors have no competing interest to report.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"114"}}