Primary Hyperparathyroidism from an Ectopic Retrosternal Parathyroid Adenoma

Primary hyperparathyroidism is one of the common endocrine abnormalities. It is estimated that 0.3-8% of patients with primary hyperparathyroidism are originated from ectopic parathyroid adenomas(s). Medical management is recommended if patient is asymptomatic. However if the patient has clinical manifestations of bone disease, nephrolithiasis, hypophosphatemia, renal dysfunction, neuropsychological symptoms etc, a surgical intervention is guaranteed. Here we reported a patient presented with neuropsychological symptoms, possibly related to hypercalcemia induced by an ectopic parathyroid adenoma in a relatively rare location of retrosternum. After parathyroidectomy, patient’s neuropsychological symptoms resolved.