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

Brent D. Bauman, Maria Evasovich, Amanda Louiselle, Eugene Zheng, Kevin Goodwin, Miroslav Sekulic, Faqian Li, Raphael Andrade, Bradley J. Segura

Research output: Contribution to journalArticle

Abstract

Background: Hyperparathyroidism (HPT) is a rare disease in the pediatric population, and optimal management may be unclear if it is due to an occult parathyroid adenoma. We present a case report of a pediatric patient with an occult, ectopic, supernumerary, parathyroid adenoma. Case presentation: A 13-year-old female who initially presented with anxiety was diagnosed with HPT. Preoperative imaging and bilateral neck exploration with four-gland biopsy were negative for any parathyroid adenoma. Postoperative MRI identified a thymic mass. She subsequently underwent video-assisted thoracoscopic thymectomy with resection of an intrathymic parathyroid adenoma. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)995-999
Number of pages5
JournalJournal of Pediatric Endocrinology and Metabolism
Volume30
Issue number9
DOIs
StatePublished - Aug 28 2017

Keywords

  • 1Pediatrics
  • Hyperparathyroidism
  • Parathyroid adenoma
  • Parathyroidectomy

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