EXCISION OF A PARATHYROID ADENOMA OF THE AORTOPULMONARY WINDOW DURINGTHE INITIAL THORACOSCOPY

Objectives: Neck exploration is usually required in all cases of prima ry hyperparathyroidism. Without a precise localization preoperatively cervicotomy may be unsuccessful, especially in case of an ectopic aden oma. Case Report: A patient with primary hyperparathyroidism due to a solitary adenoma localized in the middle mediastinum was identified on preoperative computed tomography and technetium-99m-sestamibi radionu clide scan, The tumor was successfully removed at thoracoscopy without neck exploration. Discussion: Preoperative localization of primary hy perparathyroid tumors is not indicated in all patients, In some select ed cases (acute hypercalcemia, reoperation, serious illness) prior nec k exploration would be useful in guiding the surgeon.