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What is Kamli Rath 75 yrs old woman present with post-myocardial infarction after 6 weeks with mild CHF. There was past H/O neck surgery for parathyroid adenoma 5 years ago, EKG shows slow atrial fibrillation. Serum Ca+2  13.0 mg/L and urinary Ca2+ is 300 mg/ 24 hr. On examination, there is small mass in the Para tracheal position behind the right clavicle. Appropriate management at this time is - and explain in detail?
This patient operated previously for parathyroid adenoma, is having recurrent hyperparathyroidism.
In the setting of recent myocardial infarction, CHF and atrial fibrillation, any operation carries a high risk. Furthermore, an operation on a previously operated neck is quite difficult.
Alcohol ablation of the mass with ultrasound guidance or angiographic embolization is preferred in this setting.