{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:19:35Z","timestamp":1760059175394,"version":"build-2065373602"},"reference-count":13,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T00:00:00Z","timestamp":1748390400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Hypercalcemia is frequently attributed to primary hyperparathyroidism, commonly a result of parathyroid adenomas. Ectopic hyperparathyroidism is characterized by hyperfunctioning parathyroid tissue located outside of expected anatomical locations of endocrine tissue. In this report, we present a rare case of hypercalcemia secondary to a mediastinal ectopic parathyroid adenoma, located between the left atrium and pulmonary artery. Given the unique location of the ectopic gland, diagnosis was delayed with additional complications that followed due to difficulty accessing the gland surgically. Despite this, urgent surgical removal of the ectopic gland allowed for remarkable improvement in presenting symptoms. This clinical case highlights diagnostic and therapeutic challenges that present a unique situation worthy of clinical discussion.<\/jats:p>","DOI":"10.3390\/jcdd12060201","type":"journal-article","created":{"date-parts":[[2025,5,28]],"date-time":"2025-05-28T03:52:08Z","timestamp":1748404328000},"page":"201","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Rare Case of Hypercalcemia from Mediastinal Ectopic Hyperparathyroidism"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7969-0044","authenticated-orcid":false,"given":"Nasrin","family":"Dhapa","sequence":"first","affiliation":[{"name":"Sutter Roseville Medical Center, Graduate Medical Education, Roseville, CA 95661, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2134-8818","authenticated-orcid":false,"given":"Lamar","family":"Alocozy","sequence":"additional","affiliation":[{"name":"Sutter Roseville Medical Center, Graduate Medical Education, Roseville, CA 95661, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rumana","family":"Khan","sequence":"additional","affiliation":[{"name":"Sutter Roseville Medical Center, Graduate Medical Education, Roseville, CA 95661, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1590\/S0004-27302012000600009","article-title":"Persistent primary hyperparathyroidism: An uncommon location for an ectopic gland\u2014Case report and review","volume":"56","author":"Gouveia","year":"2012","journal-title":"Arq. Bras. Endocrinol. Metab."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1055\/s-0032-1327628","article-title":"Ectopic parathyroid glands and their anatomical, clinical and surgical implications","volume":"120","author":"Noussios","year":"2012","journal-title":"Exp. Clin. Endocrinol. Diabetes"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"977","DOI":"10.4158\/EP10052.OR","article-title":"Characteristics of ectopic parathyroid glands in 145 cases of primary hyperparathyroidism","volume":"16","author":"Mendoza","year":"2010","journal-title":"Endocr. Pr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1530\/EC-24-0265","article-title":"False-negative 99mTc-sestamibi scans: Factors and outcomes in primary hyperparathyroidism","volume":"13","author":"Alemadi","year":"2024","journal-title":"Endocr. Connect."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1530\/EJE-21-0038","article-title":"Comparison of the diagnostic accuracy of 18F-Fluorocholine PET and 11C-Methionine PET for parathyroid localization in primary hyperparathyroidism: A systematic review and meta-analysis","volume":"185","author":"Bioletto","year":"2021","journal-title":"Eur. J. Endocrinol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1007\/BF02439553","article-title":"Localization of ectopic parathyroid glands using technetium-99m sestamibi imaging: Comparison with magnetic resonance and computed tomographic imaging","volume":"24","author":"Ishibashi","year":"1997","journal-title":"Eur. J. Nucl. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2391","DOI":"10.1002\/jbmr.4682","article-title":"Management of Primary Hyperparathyroidism","volume":"37","author":"Bilezikian","year":"2022","journal-title":"J. Bone Min. Res."},{"key":"ref_8","first-page":"782","article-title":"Primary hyperparathyroidism caused by an ectopic parathyroid adenoma in an uncommon location: A case report","volume":"16","author":"Khalaf","year":"2021","journal-title":"J. Taibah. Univ. Med. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1308\/003588415X14181254789088","article-title":"Mediastinal parathyroid adenomas and their surgical implications","volume":"97","author":"Hu","year":"2015","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1038\/nrendo.2017.104","article-title":"Primary hyperparathyroidism","volume":"14","author":"Walker","year":"2018","journal-title":"Nat. Rev. Endocrinol."},{"unstructured":"Sadiq, N.M., Anastasopoulou, C., Patel, G., and Badireddy, M. (2024, October 27). Hypercalcemia, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK430714\/.","key":"ref_11"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1007\/s00268-011-1404-0","article-title":"Thoracoscopic removal of mediastinal parathyroid lesions: Selection of surgical approach and pitfalls of preoperative and intraoperative localization","volume":"36","author":"Iihara","year":"2012","journal-title":"World J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1097\/SLA.0b013e3181c1cfb0","article-title":"Thoracoscopic removal of mediastinal parathyroid glands: A critical appraisal of an emerging technique","volume":"251","author":"Randone","year":"2010","journal-title":"Ann. 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