Robotic Mediastinal Parathyroidectomy in a Patient with Maxillary Giant Cell Tumor

Abstract

A 50-year-old woman with a maxillary giant cell tumor had primary hyperparathyroidism from a mediastinal parathy roid adenoma. Computed tomography showed a mildly enhanced, oval soft tissue nodule (2.5 × 1.5 × 1.7 cm) at the anterosuperior mediastinum. Mediastinal parathyroidectomy was performed with a 3-arm surgical robot. After surgery, the plasma parathyroid hormone level decreased markedly (before surgery, 70.5 pg/ml; after surgery, 5.5 pg/ml; normal reference range, 1.6 to 6.9 pg/ml). The 3-dimensional visualization, high-dexterity, and full range of motion of the ro botic system provided an efficient and safe surgical procedure for the mediastinal tumor. The purpose of this case study is to show the feasibility and effectiveness of robot assisted dissection for mediastinal parathyroid gland and to demon strate the giant cell tumor of the bone can regress after resection of parathyroid adenoma.