日気食会報，73（3），2022113：567─572, 2003.16） Erbil Y, Kapran Y, I■sever H, et al：The positive effect of adenoma weight and oxyphil cell content on preoperative localization with 99mTc-sestamibi scanning for primary hyperparathyroidism. Am J Surg 195：34─39, 2008.17） 堀内 登：副甲状腺ホルモンの構造と機能．日本骨代謝学会雑誌3：16, 1985.18） Otto D, Boerner AR, Hofmann M, et al：Pre-oper-Ectopic Parathyroid Adenoma Diagnosed by 11C-Met-PET/CT and Localized Intraoperative Vital Staining Using Methylene BlueJ. Jpn. Bronchoesophagol. Soc., 73 : 245─250, 2022Ectopic parathyroid tumors present in the mediastinum are often buried in the thymus and adipose tissue, making their identification difficult. We report a case in which an ectopic parathy-roid tumor within the mediastinum was identified and resected using intraoperative vital staining with methylene blue. The patient was a 66-year-old female diagnosed with primary hyperparathy-roidism and treated with oral medication. Due to difficulty in adequately controlling serum calcium levels, MIBI scintigraphy, 11C-Met-PET/CT, and contrast-enhanced CT were performed. With a di-agnosis of MIBI scintigraphy-negative and 11C-Met-PET/CT-positive upper mediastinal ectopic parathyroid tumor, the patient was referred to our department for surgical management. The le-sion was expected to be difficult to identify；therefore, resection of the ectopic parathyroid adeno-ma was performed using intraoperative vital staining with methylene blue. A blue-stained mass was easily located in the adipose tissue on the back of the sternum and removed. There were no significant anesthetic or postoperative complications, and this method may contribute to reduced operating times and more reliable outcomes.methionine, 11C methionine positron emission tomography/computed tomographyKey words : primary hyperparathyroidism, ectopic parathyroid adenoma, methylene blue, ative localisation of hyperfunctional parathyroid tissue with 11C-methionine PET. Eur J Nucl Med Mol Imaging 31：1405─1412, 2004.19） 中本裕士，早川延幸：内分泌疾患におけるPET副甲状腺．内分泌甲状腺外会誌32：106─111, 2015.20） Beggs AD, Hain SF：Localization of parathyroid adenomas using 11C-methionine positron emission tomography. Nucl Med Commun 26：133─136, 2005.2501）Department of Otorhinolaryngology, Kohka Public Hospital, Shiga and 2）Department of Otorhinolaryngology-Head and Neck Surgery, Shiga University of Medical Science, ShigaYoshihito Kubo, M.D.1）, Hideaki Kouzaki, M.D., Ph.D.2）, and Takeshi Shimizu, M.D., Ph.D.2）
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