Parathyroid crisis of unusual features in a child

Abstract

Background. A case of familial parathyroid crisis resulting from presumptive cancer in a 14‐year‐old boy impressed the authors with its rarity and need for recognition. Methods. The authors performed a retrospective review of the relevant literature and described the case. Results. The case report cited is the eighth example of parathyroid cancer occurring in a child younger than 16 years of age. It represents the first example of malignant parathyroid crisis because of familial hyperparathyroidism and illustrates the demand for appropriate diagnosis and methods of management in parathyroid cancer. Conclusions. Familial hyperparathyroidism may become manifest in young patients, which justifies screening among affected families to avoid serious sequelae of disease. Parathyroid cancer is an example of a malignant neoplasm in the young and is managed best by en bloc resection of primary disease, appropriate neck dissection for nodal involvement, and aggressive resection for recurrence, if possible, to control the lethal effects of hypercalcemia; this permits prolonged survival even in discouraging situations.

Parathyroid carcinoma in a child: an unusual case of an ectopically located malignant parathyroid gland with tumor invading the thymus

“…The youngest case to date was reported in an 8-year-old female with a family history of primary hyperparathyroidism, suggesting a genetic predisposition [6]. All other cases have been sporadic parathyroid carcinomas, with presenting symptoms related to severe hypercalcemia because of significantly elevated PTH levels [1][2][3][4][5][6].…”

“…Six cases have been presented in children younger than 16 years [1][2][3][4][5][6]. The youngest case to date was reported in an 8-year-old female with a family history of primary hyperparathyroidism, suggesting a genetic predisposition [6].…”

“…However, specific examination findings and symptoms are more commonly observed in parathyroid carcinoma. Although a benign adenoma infrequently presents with neck mass, more than 50% of adult cases and 100% of reported pediatric cases of parathyroid carcinoma have presented with a palpable neck mass [1][2][3][4][5][6]8]. Severe hypercalcemia (N14 mg/dL) with PTH levels ranging from 3 to 10 times greater than the normal limit is more common in a patient with parathyroid carcinoma [7].…”

Severe Primary Hyperparathyroidism Caused by Parathyroid Carcinoma in a 13‐Year‐Old Child; Novel Findings From HRpQCT

“…A review of the literature identified only 12 other pediatric cases (Supplementary Table S1). Demographic details appear to match those of our patient with the median age of presentation reported to be 13 years of age and a near 1:1 male‐to‐female ratio. Of the eight cases in the literature with follow‐up and relapse data, 3 patients appear to have relapsed with pulmonary metastases within a timeframe of 6 months to 5 years.…”

Ultrasonographic evaluation of thyroid nodules: comparison of ultrasonographic, cytological, and histopathological findings

“…Clinical approach in nondiagnostic thyroid nodules is a controversial issue. Prevalence of malignancy in nondiagnostic cytology was reported to be 9-37% [28,29]. We found a higher malignancy rate (64.3%) in our series.…”