Hyperparathyroidism--a life-threatening disease in 1978. A case report.

In a patient with hyperparathyroidism (HPT) two neck explorations with identification of three normal parathyroid glands were carried out. Cervical and mediastinal vein catheterization with blood sampling for determination of parathyroid hormone (PTH) confirmed drainage of large amounts of PTH to a mediastinal vein. Two thoracic explorations were negative anterior and posterior mediastinum). The operations were performed during 1971 and 1978 and extensive, progrediating decalcification with brown tumour formation was radiologically demonstrated during that time. Diminished renal function, skeleton pain and mental depression necessitated a last exploration, at which a 2 cm large parathyroid adenoma was found in the left carotid sheath just below the left mastoid process. The adenoma was drained into mediastinal veins through long anastomotic branches.