<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0026-1742</journal-id>
<journal-title><![CDATA[Revista de la Facultad de Medicina (México)]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. Fac. Med. (Méx.)]]></abbrev-journal-title>
<issn>0026-1742</issn>
<publisher>
<publisher-name><![CDATA[Universidad Nacional Autónoma de México, Facultad de Medicina]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0026-17422021000200038</article-id>
<article-id pub-id-type="doi">10.22201/fm.24484865e.2021.64.2.06</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Escisión transcervical de un adenoma paratiroideo mediastínico gigante]]></article-title>
<article-title xml:lang="en"><![CDATA[Transcervical Excision of a Giant Mediastinal Parathyroid Adenoma]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Barrientos López]]></surname>
<given-names><![CDATA[Isaías Adrián]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castillo Ventura]]></surname>
<given-names><![CDATA[Bertha Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital General &#8220;Dr. Manuel Gea González&#8221;  ]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<volume>64</volume>
<numero>2</numero>
<fpage>38</fpage>
<lpage>45</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S0026-17422021000200038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S0026-17422021000200038&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S0026-17422021000200038&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen El hiperparatiroidismo primario (HPTP) es el tercer trastorno neuroendocrino más común, cuya principal causa es el adenoma paratiroideo. Dentro de la clasificación aquellos adenomas que pesan más de 3.5 g se clasifican como adenomas paratiroideos gigantes (APG), se asocian a una peor evolución y malignidad. El propósito de este artículo es presentar nuestro enfoque diagnóstico y terapéutico, en el abordaje de una paciente con HPTP asociado a un APG mediastínico. Una búsqueda en la literatura internacional de los últimos 10 años reveló que solo otros 8 centros han informado la extracción de un APG de localización y dimensiones similares al nuestro.  Presentación del caso: Mujer de 66 años con antecedente de bocio multinodular, se solicitan perfil tiroideo y medición de parathormona (PTH) con reporte de 350.60 pg/mL. Se decidió realizar una gammagrafía tiroidea/paratiroidea con 99mTc sestaMIBI que reportó persistencia de una zona focal de la concentración localizada en topografía de polo inferior del lóbulo tiroideo derecho. Se complementó dicho estudio con SPECT-CT, donde se reportó imagen de paratiroides inferior derecha hiperfuncionante compatible con adenoma y se diagnosticó a la paciente con HPTP. Finalmente, se realizó resección obteniendo tumoración de 7.0 × 4.5 × 2.0 cm, con un peso de 24.5 g.  Conclusiones: Nuestro caso destacó el uso de los estudios de imagen para facilitar la localización y lograr el diagnóstico aunado a la presentación clínica y el perfil bioquímico. El tratamiento selectivo se logró de manera segura a través de una técnica transcervical mínimamente invasiva, combinada con la medición de los niveles de PTH.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Primary hyperparathyroidism (HPTP) is the third most com- mon neuroendocrine disorder, its main cause is parathyroid adenoma. Within the classification, those adenomas that weigh more than 3.5 g are classified as giant parathyroid adenomas (APG), and are associated with a worse evolution and malignancy. The purpose of this article is to present our diagnostic and therapeutic approach of a patient with HPTP associated with a mediastinal APG. A search in the international literature of the last 10 years revealed that only 8 other centers have reported the extraction of an APG of similar dimensions to ours and in a similar location.  Case presentation: A 66-year-old woman with a history of multinodular goiter, thyroid profile and parathormone (PTH) measurement were requested, with a report of 350.60 pg/ mL. A thyroid/parathyroid scintigraphy was performed with 99mTc sestaMIBI which reported persistence of a focal area of the concentration located in the topography of the lower pole of the right thyroid lobe. This study was complemented with SPECT-CT, which reported an image of hyperfunctioning right inferior parathyroid compatible with adenoma and the patient was diagnosed with PTH. Finally, resection was performed, obtaining a tumor measuring 7.0 × 4.5 × 2.0 cm, with a weight of 24.5 g.  Conclusions: Our case highlights the use of imaging studies to facilitate localization and achieve diagnosis together with clinical presentation and biochemical profile. Selective treatment was achieved safely through a minimally invasive transcervical technique, combined with the measurement of PTH.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Adenoma paratiroideo]]></kwd>
<kwd lng="es"><![CDATA[neoplasia]]></kwd>
<kwd lng="es"><![CDATA[hipercalcemia]]></kwd>
<kwd lng="es"><![CDATA[hiperparatiroidismo primario]]></kwd>
<kwd lng="es"><![CDATA[reporte de caso]]></kwd>
<kwd lng="en"><![CDATA[Parathyroid adenoma]]></kwd>
<kwd lng="en"><![CDATA[neoplasia]]></kwd>
<kwd lng="en"><![CDATA[hypercalcemia]]></kwd>
<kwd lng="en"><![CDATA[primary hyperparathyroidism]]></kwd>
<kwd lng="en"><![CDATA[case report]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neagoe]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sala]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Borda]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Mogoantá]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[M&#369;hlfay]]></surname>
<given-names><![CDATA[G.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinicopathologic and therapeutic aspects of giant parathyroid adenomas - three case reports and short review of the literature]]></article-title>
<source><![CDATA[Rom J Morphol Embryol.]]></source>
<year>2014</year>
<volume>55</volume>
<numero>^s2</numero>
<issue>^s2</issue>
<supplement>2</supplement>
<page-range>669-74</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Griebeler]]></surname>
<given-names><![CDATA[Marcio L]]></given-names>
</name>
<name>
<surname><![CDATA[Kearns]]></surname>
<given-names><![CDATA[Ann E]]></given-names>
</name>
<name>
<surname><![CDATA[Ryu]]></surname>
<given-names><![CDATA[Euijung]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Secular trends in the incidence of primary hyperparathyroidism over five decades (1965-2010)]]></article-title>
<source><![CDATA[Bone]]></source>
<year>2015</year>
<volume>73</volume>
<page-range>1-7</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mendoza]]></surname>
<given-names><![CDATA[VZ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hiperparatiroidismo primario. Experiencia en el Hospital de Especialidades Centro Médico Nacional Siglo XXI]]></article-title>
<source><![CDATA[Revista de Endocrinología y Nutrición]]></source>
<year>2009</year>
<volume>17</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>13-20</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sadiq]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
<name>
<surname><![CDATA[Naganathan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Badireddy]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Hypercalcemia]]></article-title>
<source><![CDATA[StatPearls]]></source>
<year>2020</year>
<publisher-name><![CDATA[StatPearls Publishing]]></publisher-name>
</nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Silverberg]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lewiecki]]></surname>
<given-names><![CDATA[EM]]></given-names>
</name>
<name>
<surname><![CDATA[Mosekilde]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Peacock]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Rubin]]></surname>
<given-names><![CDATA[MR.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Presentation of asymptomatic primary hyperparathyroidism: proceedings of the third international workshop]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2009</year>
<volume>94</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>351-65</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Marcocci]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Cetani]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Clinical practice. Primary hyperparathyroidism]]></article-title>
<source><![CDATA[N Engl J Med]]></source>
<year>2011</year>
<volume>365</volume>
<numero>25</numero>
<issue>25</issue>
<page-range>2389- 97</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Spanheimer]]></surname>
<given-names><![CDATA[PM]]></given-names>
</name>
<name>
<surname><![CDATA[Stoltze]]></surname>
<given-names><![CDATA[AJ]]></given-names>
</name>
<name>
<surname><![CDATA[Howe]]></surname>
<given-names><![CDATA[JR]]></given-names>
</name>
<name>
<surname><![CDATA[Sugg]]></surname>
<given-names><![CDATA[SL]]></given-names>
</name>
<name>
<surname><![CDATA[Lal]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Weigel]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Do giant parathyroid adenomas represent a distinct clinical entity?]]></article-title>
<source><![CDATA[Surgery]]></source>
<year>2013</year>
<volume>154</volume>
<numero>4</numero>
<issue>4</issue>
<page-range>714-9</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yao]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Singer]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Roth]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Sassoon]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Ye]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[AE]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Weight of normal parathyroid glands in patients with parathyroid adenomas]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2004</year>
<volume>90</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>595</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cupisti]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Dotzenrath]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Simon]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Therapy of suspected intrathoracic parathyroid adenomas]]></article-title>
<source><![CDATA[Langenbecks Arch Surg]]></source>
<year>2002</year>
<volume>386</volume>
<page-range>488-93</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Caporale]]></surname>
<given-names><![CDATA[DM]]></given-names>
</name>
<name>
<surname><![CDATA[Bobbio]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Accordino]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Ectopic mediastinal parathyroid adenoma]]></article-title>
<source><![CDATA[Acta Biomed]]></source>
<year>2003</year>
<volume>74</volume>
<page-range>157-9</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Neumann]]></surname>
<given-names><![CDATA[DR]]></given-names>
</name>
<name>
<surname><![CDATA[Obuchowski]]></surname>
<given-names><![CDATA[NA]]></given-names>
</name>
<name>
<surname><![CDATA[Difilippo]]></surname>
<given-names><![CDATA[FP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Preoperative 123I/99mTc-sestamibi subtraction SPECT and SPECT/ CT in primary hyperparathyroidism]]></article-title>
<source><![CDATA[J Nucl Med]]></source>
<year>2008</year>
<volume>49</volume>
<page-range>2012-7</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bilezikian]]></surname>
<given-names><![CDATA[JP]]></given-names>
</name>
<name>
<surname><![CDATA[Khan]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Potts]]></surname>
<given-names><![CDATA[JT]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Third International Workshop on the Management of Asymptomatic Primary Hyperthyroidism. Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the third international workshop]]></article-title>
<source><![CDATA[J Clin Endocrinol Metab]]></source>
<year>2009</year>
<volume>94</volume>
<numero>2</numero>
<issue>2</issue>
<page-range>335-9</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Udelsman]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Lin]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Donovan]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The superiority of minimally invasive parathyroidectomy based on 1650 consecutive patients with primary hyperparathyroidism]]></article-title>
<source><![CDATA[Ann Surg]]></source>
<year>2011</year>
<volume>253</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>585-91</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Shields]]></surname>
<given-names><![CDATA[TW]]></given-names>
</name>
<name>
<surname><![CDATA[Immerman]]></surname>
<given-names><![CDATA[SC]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Mediastinal parathyroid cysts revisited]]></article-title>
<source><![CDATA[Ann Thorac Surg]]></source>
<year>1999</year>
<volume>67</volume>
<page-range>581-90</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
