Ectopic parathyroid adenoma

Ectopic parathyroid glands can significantly impact morbidity associated with parathyroid surgery, including the need for reoperation. Due to their longer migratory path during embryogenesis, the inferior parathyroid glands have a greater probability of becoming ectopic. While most ectopic parathyroid glands are accessible through a cervical incision, some require access to the mediastinum via either thoracotomy or a minimally invasive approach. Preoperative localization of parathyroid adenomas correlates with successful surgical resection and can alter the operative approach depending on ectopic gland location. Most surgical centers perform some combination of preoperative and/or intraoperative localization techniques prior to reoperation for persistent or recurrent primary hyperparathyroidism (PHPT).