Mediastinal parathyroid adenoma; report of a case with unusual fatal course.

Abstract

ASKANAZY and Erdheim 1 in 1902 and 1903 observed at necropsy cases of diffuse osteitis fibrosa cystica associated with parathyroid tumors, and they speculated on a causal relationship between the two pathologic conditions. Mandl 2 in 1925 first removed a parathyroid tumor from the neck of a patient with this syndrome with good immediate result. Thereafter, case reports of parathyroid adenoma with skeletal demineralization appeared with increasing frequency. Surgical removal of the adenomas was usually curative. In these cases, skeletal signs and symptoms, such as spontaneous fractures, bone pains and bony swellings, suggested the correct diagnosis. Albright and his colleagues 3 at the Massachusetts General Hospital collected the largest series of cases of hyperparathyroidism. They established the important fact that renal disease, particularly nephrolithiasis and nephrocalcinosis, occurred with hyperparathyroidism even more commonly than demonstrable skeletal lesions. Keating 4 in a large series of cases that were observed at the Mayo