Ectopic parathyroid adenomas in the mediastinum are rare causes of primary hyperparathyroidism. We report two cases of mediastinal parathyroid adenoma. Functioning parathyroid lesion was localized with the help of nuclear single-photon emission computed tomography scan in both the patients. Video assisted thoracoscopic surgical (VATS) removal of the parathyroid lesions were done. Intraoperative confirmation of parathyroid adenoma was done by frozen section. Further confirmation was done by routine histopathological examination of specimen postoperatively. One patient had left vocal cord paralysis postoperatively. Localization by functional imaging is essential. Minimally invasive methods such as VATS are useful in removing mediastinal parathyroid hyperfunctioning lesions, which carries early postoperative recovery and less complications.
Résumé Les adénomes parathyroïdes ectopiques dans le mediastinum sont des causes rares de l'hyperparathyroïdie primaire. Nous rapportons deux cas d'adénome parathyroïde mediastinal. La lésion parathyroïde de fonctionnement a été localisée avec l'aide du balayage nucléaire de SPECT dans les deux patients. L'enlèvement thoracoscopic aidé vidéo de chirurgie (VATS) des lésions parathyroïdes ont été faits. La confirmation intraopératoire de l'adénome parathyroïde a été faite par section gelée. Une confirmation supplémentaire a été faite par l'examen histopathologique courant du spécimen post opératoirement. Un patient avait laissé la paralysie de corde vocale postopératoirement. La localisation par imagerie fonctionnelle est essentielle. Les méthodes mini-invasives telles que le VATS sont utiles pour enlever les lésions de fonctionnement hyper-médiantinal, qui portent le rétablissement postopératoire tôt et moins de complications.
Adenoma/surgery , Hypercalcemia/etiology , Mediastinal Neoplasms/surgery , Parathyroid Neoplasms/surgery , Thoracic Surgery, Video-Assisted/methods , Adenoma/pathology , Adult , Female , Humans , Hypercalcemia/blood , Hypercalciuria/blood , Hypercalciuria/etiology , Hyperparathyroidism/etiology , Male , Middle Aged , Parathyroid Hormone/blood , Parathyroid Neoplasms/pathology , Parathyroidectomy , Thyroid Gland/pathology
Hypereosinophilic syndrome (HES) is a myeloproliferative disorder characterised by marked peripheral eosinophilia and end organ damage attributable to eosinophilia without secondary cause. Early recognition and treatment are essential to prevent morbidity and mortality. Cytoreduction with Steroids, Hydroxyurea and Imatinib are the main stay of treatment. Molecular studies like Fip1-like-1 fused with platelet derived growth factor receptor alpha (FIP1L1-PDGFRα) etc., are recommended in view of therapeutic implication. In this paper we report a rare case of HES developing in a lady 6 months after surgical removal of lymphangioma of spleen, which in itself is rare.
Pheochromocytomas are usually solid tumours. But it can present as cystic lesions in the adrenal gland. Cystic lesions in adrenal gland with hypertension needs attention to rule out pheochromocytoma. If ignored, it may lead to hypertensive emergency, multisystem crisis and death. Early diagnosis with biochemistry, Computed Tomography (CT) or Magnetic Resonance Imaging (MRI) of abdomen, proper functional imaging like Meta Iodo Benzyl Guanidine (MIBG) scan is essential. Proper preoperative preparation is important to prevent hypertensive crisis during and after surgery. We are reporting a case of cystic pheochromocytoma in a young male.
