Author year (reference) Age/sex Presentation Imaging Tc-99 MIBI Serum calcium level Serum PTH level Surgery Size Weight Follow-up Hargreaves and Wright [23 ] 66/F Change in tone of voice and nonspecific left should pain Large right retrotracheal posterior mediastinal mass, extending from high in the peritracheal region to below the hilum (chest roentgenogram) No data 13.23 mg/dl No data Right posterolateral thoracotomy 190 g No data Ogawa et al. [24 ] 72/F Hypercalcemia for evaluation Computed tomographic scan with 3 dimensional reconstruction images revealed a tumor behind the thoracic esophagus An abnormal accumulation of MIBI at the upper mediastinum 12.5 mg/dl 650 pg/dl A right-sided thoracotomy was performed to explore the mediastinum. An adenoma situated behind the thoracic esophagus was resected 3 cm 4.25 g Patient had normal calcium and PTH levels and was discharged on postoperative day 7 Yun et al. [25 ] 64/F Abnormal test results Elongated mass in the posterior mediastinum, extending from the level of the right subclavian artery to the halfway point of the right esophageal wall (CT) Abnormal uptake in the mediastinum area 13.5 mg/dl 705 pg/dl Right 6th posterolateral intercostal thoracotomy No data No recurrence in 2 years Kiverniti et al. [26 ] 39/F Acute stridor, mild dysphagia, arthralgia, mood swings, malaise, and lethargy Presence of a soft-tissue smooth, solid tumor in the cervical esophagus at the level of the thoracic inlet; the tumor was predominately in the right posterior lateral side (CT) No data 9.7 mg/dl No data Thoraco-cervical approach and a partial longitudinal sternal split No data No recurrence at 3 months follow-up Çakmak et al. [27 ] 63/F Headache and fatigue Posterior mediastinal mass near the esophagus and trachea (CT) Revealed mass in mediastinum 13.2 mg/dl 642 pg/ml Right posterolateral thoracotomy 145 g No data Migliore et al. [28 ] 65/F Persistent hypercalcemic syndrome Presence of a “missed” 7 cm mass in the posterior mediastinum (CT) Confirmed CT findings No data No data Remedial right video-assisted minithoracotomy 7 cm 95 g No data Bayraktar et al. [29 ] 62/M Fatigue, unable to walk, and low back pain (lumbalgia) Bilateral posterior mediastinal masses with a concomitant multinodular goiter (neck ultrasonography) No significant findings 19.24 mg/dl 3,436 pg/dl (343.6 pg/ml) Collar incision Right inferior: Right inferior: 74 g No recurrence in 12 months Świrta et al. [30 ] 52/M Persistent hypercalcemia Ultrasound showed single focal lesions below the lower poles of thyroid lobes An increased accumulation of marker in the right view and the left lower parathyroid gland 2.85 mmol/l (11.4 mg/dl) 1050 pg/ml Bilateral neck reexploration. Upper posterior mediastinal enlarged parathyroid close to the left recurrent laryngeal nerve was excised in 2010 6 cm in diameter 22.8 g In 2013, another adenoma was excised. No recurrence in 12 months Ebrahimpur et al. [31 ] 67/F Nausea, vomiting, polydipsia, and polyuria Solid-cystic lesion in the superior posterior mediastinum, posterior to trachea (MRI) Persistent radiotracer uptake in the right middle of the mediastinum 13 mg/dl 291 pg/ml Open thoracotomy No data No recurrence Zeng et al. [32 ] 64/F Chronic generalized ostealgia and hypercalcemia Abnormal upper-left mediastinal shadow (CT) Radiotracer accumulation in posterior superior mediastinum near the esophagus 12.79 mg/dl 24.83 mmol/l Video-assisted mediastinoscopy No data No data No data Miller et al. [33 ] 53/M Nonspecific malaise and fatigue Well defined, bilobed, uniformly enhancing mass to the left of the esophagus, extending from the suprasternal notch and descending in the posterior mediastinum to the level of the carina (CT) Unusual linear region of increased intensity to the left of the mediastinum 11.22 mg/dl 179.17 pg/ml Trans-cervical approach 30.9 g No recurrence Nastos et al. [34 ] 54/M Nephrolithiasis, hypertension, and severe osteoporosis Ultrasound did not recognize any pathological findings Fusion MIBI with SPECT revealed a 6 cm hyperfunctioning retroesophageal parathyroid gland 12.1 mg/dl 277 pg/ml Conventional 4 cm collar incision 6.5 cm maximal dimension 8.3 g Postoperatively, calcium and PTH levels were normalized and patient discharged on day 3 post-op Amr et al. (current case) 74/M Generalized weakness and reduced level of consciousness CT scan showed Right lower parathyroid lesion extending into the mediastinum 19.9 mg/dl 2234 pg/ml Single port thoracoscopy converted to open thoracotomy over 4th intercostal space. Mass found between vena cava, azygos vein, and the spine 42 g No recurrence in 18 months
