{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:12Z","timestamp":1753893312159,"version":"3.41.2"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T00:00:00Z","timestamp":1658880000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Secondary hyperparathyroidism (SHPT) is a common complication in hemodialysis patients with chronic renal failure uremia. For severe SHPT, parathyroidectomy is effective. Owing to the variability in parathyroid anatomy, surgical parathyroidectomy can be complex and many patients experience recurrent SHPT, which may require repeated surgery. These cases pose significant challenges to surgeons.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case description<\/jats:title><jats:p>An elderly woman with recurrent severe SHPT was admitted to our hospital. Preoperative methoxyisobutylisonitrile (MIBI) examination found a large ectopic parathyroid gland in the superior mediastinum, and she underwent reoperative parathyroidectomy. A large parathyroid gland in the right anterior mediastinum and another parathyroid gland in the left lingual lobe of the thymus were removed. The patient had postoperative hypocalcemia that was successfully corrected with calcium supplementation <jats:italic>via<\/jats:italic> femoral vein catheterization. During the 1-year postoperative follow-up, the patient's iPTH was well controlled and her blood calcium was within the normal range.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We report a case of parathyroidectomy to remove multifocal ectopic hyperplastic parathyroid tissue in the mediastinum. Preoperative MIBI accurately detected the lesions. Calcium supplementation <jats:italic>via<\/jats:italic> femoral vein catheterization successfully corrected postoperative hypocalcemia. Postoperative follow-up for 1 year indicated that the surgery was successful.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2022.921026","type":"journal-article","created":{"date-parts":[[2022,7,27]],"date-time":"2022-07-27T05:27:45Z","timestamp":1658899665000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case report: Reoperative parathyroidectomy for large ectopic hyperplastic parathyroid in the mediastinum of a patient with recurrent secondary hyperparathyroidism"],"prefix":"10.3389","volume":"9","author":[{"given":"Yong","family":"Lv","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiuyuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ling","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qing","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyu","family":"Mi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingning","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2022,7,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1007\/s11914-019-00533-x","article-title":"Controversies in the management of secondary hyperparathyroidism in chronic kidney disease","volume":"17","author":"Bellorin-Font","year":"2019","journal-title":"Curr Osteoporos Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e16388","DOI":"10.7759\/cureus.16388","article-title":"Secondary hyperparathyroidism in chronic kidney disease: pathophysiology and management","volume":"13","author":"Sr","year":"2021","journal-title":"Cureus"},{"key":"B3","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1007\/s11154-017-9421-4","article-title":"Secondary hyperparthyroidism: pathogenesis, diagnosis, preventive and therapeutic strategies","volume":"18","author":"Portillo","year":"2017","journal-title":"Rev Endocr Metab Disord"},{"key":"B4","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1186\/s12882-019-1639-9","article-title":"Efficacy and safety of cinacalcet compared with other treatments for secondary hyperparathyroidism in patients with chronic kidney disease or end-stage renal disease: a meta-analysis","volume":"21","author":"Sun","year":"2020","journal-title":"BMC Nephrol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1053\/j.ajkd.2020.02.439","article-title":"Comparative effectiveness of calcimimetic agents for secondary hyperparathyroidism in adults: a systematic review and network meta-analysis","volume":"76","author":"Palmer","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"B6","doi-asserted-by":"publisher","first-page":"254","DOI":"10.1016\/j.ekir.2020.11.023","article-title":"Surgical management of secondary hyperparathyroidism","volume":"6","author":"Steinl","year":"2021","journal-title":"Kidney Int Rep"},{"key":"B7","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1177\/1457496919866015","article-title":"Secondary and tertiary hyperparathyroidism: a narrative review","volume":"109","author":"van der Plas","year":"2020","journal-title":"Scand J Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"2016","DOI":"10.1210\/clinem\/dgac142","article-title":"Parathyroidectomy versus cinacalcet among patients undergoing hemodialysis","volume":"107","author":"Komaba","year":"2022","journal-title":"J Clin Endocrinol Metab"},{"key":"B9","doi-asserted-by":"publisher","first-page":"6","DOI":"10.1016\/j.asjsur.2018.04.001","article-title":"Impacts of parathyroidectomy on calcium and phosphorus metabolism disorder, arterial calcification and arterial stiffness in haemodialysis patients","volume":"42","author":"Gao","year":"2019","journal-title":"Asian J Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1016\/j.atherosclerosis.2018.08.046","article-title":"CKD, arterial calcification, atherosclerosis and bone health: inter-relationships and controversies","volume":"278","author":"Reiss","year":"2018","journal-title":"Atherosclerosis"},{"key":"B11","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1007\/s00415-005-0027-5","article-title":"Neuropsychological function in relation to serum parathyroid hormone and serum 25-hydroxyvitamin D levels. 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