Robot-Assisted Resection of a Superior Prevascular Mediastinal Ectopic Parathyroid Adenoma by Subxiphoid Approach: A Case Report

INTRODUCTION: Ectopic mediastinal parathyroid adenoma is a rare cause of primary hyperparathyroidism, which is characterized by the excessive secretion of parathyroid hormone (PTH). Complete surgical resection is essential for curative treatment, making accurate intraoperative localization of the tumor a critical challenge. While superior mediastinal tumors have traditionally required invasive procedures such as median sternotomy, minimally invasive techniques, including video-assisted thoracoscopic surgery and robot-assisted surgery, have recently been adopted. However, in the lateral approach, visualization and instrument maneuverability beyond the left brachiocephalic vein are limited. In this case, we employed a robot-assisted subxiphoid approach combined with radio-navigation and intraoperative frozen section diagnosis for a superior prevascular mediastinal tumor adjacent to the jugular notch.