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

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

J Pediatr Endocrinol Metab. 2017 Aug 28;30(9):995-999

Authors: Bauman BD, Evasovich M, Louiselle A, Zheng E, Goodwin K, Sekulic M, Li F, Andrade R, Segura BJ

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.

PMID: 28809753 [PubMed - indexed for MEDLINE]

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