Parathyroid crisis of unusual features in a child.

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.