Introduction: Mediastinal parathyroid adenomas are uncommon and present a challenge in the treatment of hyperparathyroidism. They are not always demonstrated on standard pre-operative imaging and represent one possible cause of failure to cure at primary surgery. They traditionally necessitate a manubriotomy or sternotomy which is associated with the additional potential morbidity related to bone cutting and with a cosmetically undesirable incision that is at odds with the size of the culprit gland.
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