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BRIEF RESEARCH REPORT article

Front. Surg.
Sec. Visceral Surgery
Volume 11 - 2024 | doi: 10.3389/fsurg.2024.1466080

Case Report: Indocyanine Green Angiography is Helpful for Identification of Ectopic Mediastinal Parathyroid Adenoma

Provisionally accepted
Mehmet Kostek Mehmet Kostek 1,2*Işık Çetinoğlu Işık Çetinoğlu 1,2Mehmet Taner Ünlü Mehmet Taner Ünlü 1,2OZAN ÇALIŞKAN OZAN ÇALIŞKAN 1,2Nurcihan Aygun Nurcihan Aygun 1,2Tolga Demir Tolga Demir 1,3Mehmet Uludag Mehmet Uludag 1,2
  • 1 University of Health Sciences (Turkey), Istanbul, Türkiye
  • 2 Department of General Surgery, Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye
  • 3 Şişli Hamidiye Etfal Education and Research Hospital, Istanbul, Türkiye

The final, formatted version of the article will be published soon.

    Background: Mediastinum one of the ectopic locations that parathyroid adenoma may occasionally be located. ICG Angiography is an emerging technique and its utility in primary hyperparathyroidism is under investigation. Ectopic parathyroid adenomas can be difficult to localize and studies for usefulness of ICG Angiography in this patient group are limited. In this case report, a demonstration of Indocyanine Green(ICG) Angiography for resection of ectopic mediastinal parathyroid adenoma was presented.Methods: A 55-years old female patient underwent 4-Dimentional Computed Tomography(4DCT) and Tecnetium-99m-sestamibi Scintigraphy along with Single-photon Emission Computed Tomography/Computed Tomography (SPECT/CT), and an ectopic retrosternal parathyroid adenoma were shown on anterior mediastinum. After sternotomy and opening the fascia of anterior mediastinum, 1 ml(2.5mg) ICG were injected, parathyroid adenoma was visualized. Following further dissection to achieve better imaging of vascularization, 3 ml(7.5mg) ICG were injected. After capturing ICG Angiography images, adenoma was resected and sent for frozen section.Results: Parathyroid gland was confirmed and intraoperative parathormone decrease was observed. Patient was discharged uneventfully and normocalcemia and normal parathormone levels were achieved during follow-up.Conclusions: ICG angiography is a useful visual technique which enables surgeon to comprehend anatomical position of ectopic mediastinal parathyroid adenoma on real-time fashion. This technique may help decreasing operative time and complications.

    Keywords: Hypercalcemia, Indocyanine green angiography, Parathyroid adenoma, primary hyperparathyroidism, Sternotomy

    Received: 17 Jul 2024; Accepted: 01 Oct 2024.

    Copyright: © 2024 Kostek, Çetinoğlu, Ünlü, ÇALIŞKAN, Aygun, Demir and Uludag. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Mehmet Kostek, University of Health Sciences (Turkey), Istanbul, Türkiye

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