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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 and Bradley J. Segura EMAIL logo
Published/Copyright: August 15, 2017

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.


Corresponding author: Bradley J. Segura, MD, PhD, Department of Surgery and Pediatrics, University of Minnesota, 2450 Riverside Ave S, East Building MB505, Minneapolis, MN 55454, USA, Phone: +(612) 626-4214, Fax: +(612) 624-6969

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2017-2-16
Accepted: 2017-7-3
Published Online: 2017-8-15
Published in Print: 2017-8-28

©2017 Walter de Gruyter GmbH, Berlin/Boston

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