Case Series: Single-port subxiphoid robotic excision of ectopic mediastinal parathyroid adenomas
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By
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Shayan Hosseinzadeh
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Alexander Chang
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Mahsa Shariat
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Nestor Villamizar
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June 5, 2026
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Clinical Scorecard: Case Series: Robotic Single-Port Subxiphoid Resection of Ectopic Parathyroid Adenomas in the Mediastinum
At a Glance
| Category | Detail |
|---|
| Condition | Ectopic mediastinal parathyroid adenomas |
| Key Mechanisms | Abnormal embryologic migration leading to persistent primary hyperparathyroidism |
| Target Population | Patients with biochemically confirmed primary hyperparathyroidism and imaging-localized anterior mediastinal parathyroid adenomas |
| Care Setting | Surgical intervention using robotic techniques |
Key Highlights
- Successful single-port subxiphoid robotic excision in 100% of cases
- Mean operative time was 150 minutes with minimal blood loss (<50 mL)
- Intraoperative PTH levels decreased by >80% post-excision, confirming biochemical cure
- Both patients discharged on postoperative day one with normalized ionized calcium
- Final pathology confirmed parathyroid adenoma in both cases
Guideline-Based Recommendations
Diagnosis
- Imaging localization of ectopic parathyroid adenomas is crucial for surgical planning
Management
- Robotic single-port subxiphoid resection is a feasible approach for ectopic adenomas
Monitoring & Follow-up
- Intraoperative PTH levels should be measured to assess surgical success
Risks
- Potential complications include injury to major mediastinal structures
Patient & Prescribing Data
Patients with ectopic parathyroid adenomas causing primary hyperparathyroidism
Robotic single-port technique offers a minimally invasive surgical option
Clinical Best Practices
- Ensure multidisciplinary discussion for surgical planning
- Optimize hyperparathyroidism medically before surgery
- Utilize intraoperative PTH monitoring to confirm excision success
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