Excision of postesophageal parathyroid adenoma in posterior mediastinum with intraoperative 99mTechnetium sestamibi scanning.

Although approximately 25% of parathyroid tumors in patients with primary hyperparathyroidism are located in the mediastinum, nearly all these tumors can be removed through cervical exploration. However, 1% to 2% of the mediastinal tumors require a transthoracic approach for removal. The mediastinal tumors are usually located in the inferior parathyroid gland, and the ectopic mediastinal tumors derived from the superior glands are extremely rare. We present a case of retroesophageal mediastinal parathyroid adenoma that developed in the left superior parathyroid gland. A thoracotomy was required to remove this tumor. Radioisotope-guided surgery was effective at identifying the tumor.