One reason for persisting hyperparathyreoidism is an ectopic adenoma not found during the operation. The case discussed here is that of a 51-year-old woman with the typical constellation of a primary hyperparathyreoidism. After revision PTH remained elevated. Further examination with MIBI-SPECT-scanning showed a focus in the left anterior mediastinum. After opening the pericard during the revision an adenoma of 1 cm size was found ventral to the ascending aorta. During follow-up PTH and calcium-levels remained stable at normal levels.

The solid-pseudopapillary tumor is a very rare entitiy of pancreatic growths which is significantly different from the adeno carcinoma concerning histomorphology as well as molecular genetics and prognosis. These tumors are mostly found in young women and have a low potential of malignancy. Wide resection in sano is the therapy of choice for most of the patients stay free of tumor.