Presentation
Recurrent renal stone disease
Patient Data
Bilateral renal stones.
A chest radiograph was performed prior to percutaneous nephrolithotomy (PCNL).
Right sided mediastinal mass, which demonstrates the hilum overlay sign.
A MIBI scan was undertaken to assess for a parathyroid adenoma.
Avid tracer uptake in the mediastinal mass visualized on plain chest radiograph, confirms it represents an ectopic parathyroid adenoma.
Case Discussion
In a small number of cases, recurrent renal stone diseases (nephrolithiasis) is due to an underlying metabolic condition. This includes primary hyperparathyroidism due to a parathyroid adenoma. Rarely these occur in an ectopic location, typically the mediastinum, rather than in the neck.