An occult ectopic parathyroid adenoma in a pediatric patient: a case report and management algorithm

Abstract

The diagnosis of pediatric HPT is increasing. Supernumerary or occult parathyroid adenomas are rare and add complexity to presurgical planning and management. Our case represents the rare occurrence of a pediatric ectopic supernumerary occult parathyroid adenoma treated with a two-stage approach utilizing multiple imaging studies. We provide a review of the pathology and propose an algorithmic approach to manage these complex patients.

Minimally Invasive Parathyroidectomy in a Child With Acute Pancreatitis

“…This is due to several factors including infrequent laboratory screening tests, the wide range of ALP levels in children and the myriad of vague, non-specific presenting symptoms such as abdominal pain, bone pain, nausea, vomiting, headache and so on. Hence, making the diagnosis of PHPT on time is often challenging and has been reported to range from as long as seven months, to more than four years [9].…”

Ectopic Parathyroid Adenoma in an 11-Year-Old Girl: Case Report and Literature Review

“…4 The use of combinations of imaging techniques, such as singlephoton emission computerized tomography (SPECT)/CT and positron emission tomography/CT, have been increasingly reported in the literature, particularly when other modalities have initially failed to reveal the source of ectopic production of parathyroid hormone (PTH). 5,6 We present the case of an 11-year-old girl incidentally diagnosed with primary hyperparathyroidism who underwent the removal of an intrathymic parathyroid adenoma. Medical record review of this patient was approved by the New York Presbyterian Brooklyn Methodist institutional review board.…”

Primary Hyperparathyroidism as a Rare Cause of Unexplained Recurrent Abdominal Pain: Case Presentation and Literature Review

“…Hyperparathyroidism is a condition characterized by increased parathyroid hormone (PTH) secretion. Patients with hyperparathyroidism usually present with nonspecific symptoms of fatigue, poor appetite, weight loss, abdominal pain, nausea, emesis, and bone pain [4]. Serum calcium and serum PTH level are essential to establish the diagnosis.…”

“…Technetium (99mTc) sestamibi scan is performed to locate the hyperfunctioning gland [5]. Ectopic parathyroid adenoma was located in 22% of all cases of children and usually close to the thymus [4]. Additionally, multiple endocrine neoplasia type 1 syndrome (MEN1) was identified in 23% of children with hyperparathyroidism, whereas only 2.6% had multiple endocrine neoplasia type 2 syndrome (MEN2) [6].…”