Ablation of mediastinal parathyroid adenomas by superselective embolization of the internal mammary artery with alcohol

Two young patients (20 and 21 years) had recurrent hyperparathyroidism following neck exploration. Non-invasive investigations failed to localize a parathyroid adenoma. In both cases selective catheterization of the internal mammary arteries combined with digital angiography demonstrated hypervascular mediastinal adenomas. Using a coaxial catheterization technique (Tracker 18 and 10), both branch arteries of the internal mammary supplying the adenoma were selectively catheterized. In one case absolute alcohol and the other a mixture of Lipiodol and absolute alcohol were used to effect the ablation. The procedures were uneventful and serum calcium levels have subsequently returned to within normal limits. The follow-up in these two cases extends to 2 1/2 years in one and 10 months in the other case.