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

2017 ◽  
Vol 30 (9) ◽  
Author(s):  
Brent D. Bauman ◽  
Maria Evasovich ◽  
Amanda Louiselle ◽  
Eugene Zheng ◽  
Kevin Goodwin ◽  
...  
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Pediatric Patient ◽  
Pediatric Population ◽  
Preoperative Imaging ◽  
Management Algorithm ◽  
Postoperative Mri ◽  
Complex Patients ◽  
Multiple Imaging ◽  
Parathyroid Adenomas

AbstractBackground: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.

scholarly journals Nontraumatic Parapharyngeal Haematoma: A Rare Lesion

2018 ◽  
Vol 2018 ◽  
pp. 1-2 ◽  
Author(s):  
Pedro Carneiro de Sousa ◽  
Inês Gambôa ◽  
Delfim Duarte ◽  
Nuno Trigueiros-Cunha
Keyword(s):  
Case Report ◽  
Parathyroid Hormone ◽  
Conservative Treatment ◽  
Parathyroid Adenoma ◽  
Parapharyngeal Space ◽  
Neck Swelling ◽  
Parathyroid Adenomas ◽  
Rare Lesion ◽  
Symptoms And Signs ◽  
Emergent Surgery

Nontraumatic haematoma of parapharyngeal space is very rare and may cause dysphagia and dyspnea. The authors present a case report of a 74-year-old woman with sudden nontraumatic neck swelling without dyspnea and with left pharyngeal bulging and endolaryngeal displacement. Parathyroid hormone elevation and imaging exams confirmed bleeding from a parathyroid adenoma. Symptoms and signs resolved after one week of conservative treatment. There are few cases of parapharyngeal haematomas caused by parathyroid adenomas. Most patients can be managed without emergent surgery, but close airway monitoring is fundamental.

scholarly journals SAT-LB65 A Rare Existence

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jiselle Aimee Yaplito Bedia ◽  
Maria Honolina S Gomez
Keyword(s):  
Primary Hyperparathyroidism ◽  
Parathyroid Adenoma ◽  
Clinical Presentation ◽  
Renal Involvement ◽  
Preoperative Imaging ◽  
Biochemical Screening ◽  
Central Target ◽  
Target Organs ◽  
Postoperative Hypoparathyroidism ◽  
Parathyroid Adenomas

Abstract Primary hyperparathyroidism is a common endocrine disorder of metabolism usually due to a parathyroid adenoma. Although, the clinical presentation of primary hyperparathyroidism has changed from Albright’s description of a disease of bones and stones, the central target organs affected by this disorder continue to be the skeleton and kidneys. With the advent of routine biochemical screening, the typical diagnosis of primary hyperparathyroidism is no longer accompanied by overt skeletal and renal involvement. Majority of the cases of primary hyperparathyroidism are due to parathyroid adenomas. Giant glands were defined as greater than the 95th percentile, characterized as glands weighing > 3.5 grams. This present case in a 54-year old female is a rare case of primary hyperparathyroidism secondary to a giant parathyroid adenoma measuring 10.7 x 8.0 x 40.0 cm and weighing 145 grams, the largest giant parathyroid adenoma reported to date, with co-existent silent thymoma, multinodular goiter and osteosclerosis of the vertebral spine, metaphorically known as the “rugger-jersey spine”. The association between thymoma and parathyroid adenoma is rare, and only 3 cases have been reported in the literature. We characterized the correlation of preoperative imaging, intraoperative location, and postoperative course, including significant postoperative hypoparathyroidism, as compared to other patients with PHPT to determine whether giant adenomas represent a clinical entity with distinct clinical characteristics. Keywords: primary hyperparathyroidism, giant parathyroid adenoma, rugger-jersey spine, thymoma Abbreviation PHPT Primary hyperparathyroidism

Arachnoid Cyst Causing an Oculomotor Nerve Palsy in a Pediatric Patient: A Case Report

2020 ◽  
Author(s):  
Lauren Hennein ◽  
Nailyn Rasool ◽  
Maanasa Indaram
Keyword(s):  
Visual Acuity ◽  
Case Report ◽  
Pediatric Patient ◽  
Arachnoid Cyst ◽  
Nerve Palsy ◽  
Pediatric Population ◽  
Oculomotor Nerve ◽  
Oculomotor Nerve Palsy ◽  
Oculomotor Palsy ◽  
Cyst Fenestration

AbstractAn arachnoid cyst causing a compressive oculomotor nerve palsy is rare in the pediatric population. We describe a case of an acquired, partial oculomotor nerve palsy in a 3-year-old boy caused by an arachnoid cyst in the left crural cistern with associated amblyopia. The patient's amblyopia was aggressively treated, and he underwent cyst fenestration. Two months postoperatively, he continued to demonstrate a partial oculomotor palsy with improved visual acuity and recurrence of the cyst. This case demonstrates that cyst fenestration may not always resolve these paretic effects, cysts may recur after fenestration, and amblyopia must be treated in this setting.

A CASE OF RECURRENT PARATHYROID ADENOMA – A CASE REPORT

2021 ◽  
pp. 27-28
Author(s):  
C. Aparna ◽  
P.Venkata Kiran Kumar ◽  
Shaila Shaila ◽  
Lakshmi Soundarya
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Male Patient ◽  
Muscle Weakness ◽  
Clinical History ◽  
Parathyroid Adenomas ◽  
Laboratory Investigations ◽  
Microscopic Picture

Parathyroid adenomas(PTH) are rare lesions. We report a case of recurrent parathyroid adenoma in a 28 year old male patient. He was operated for parathyroid adenoma, right inferior parathyroid was removed ten years bsck. Now he presented with extreme muscle weakness and renal calcinosis. Entire clinical history, laboratory investigations, microscopic picture are discussed in detail.

Preoperative imaging and localization of a mediastinal parathyroid adenoma. A case report.

2021 ◽  
Author(s):  
Theodoros Mariolis-Sapsakos ◽  
Nikolaos Anastasiou ◽  
Nikolaos Tasis ◽  
Ioannis Tsouknidas ◽  
Alexandra Gavala ◽  
...  
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Preoperative Imaging ◽  
Mediastinal Parathyroid Adenoma ◽  
Mediastinal Parathyroid

scholarly journals Sudden Odynophagia and Globus—A Unique Presentation of a Nonsecreting Parathyroid Adenoma: A Case Report and Literature Review

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Luxman Srikantha ◽  
Esmael H. Amjad ◽  
Rafic Beydoun
Keyword(s):  
Case Report ◽  
Parathyroid Adenoma ◽  
Clinical Symptoms ◽  
Surgical Excision ◽  
Laryngeal Nerve ◽  
Range Imaging ◽  
Normal Range ◽  
Parathyroid Adenomas ◽  
The Right ◽  
Point Tenderness

Parathyroid adenomas are most commonly diagnosed when symptoms consistent with primary hyperparathyroidism arise. However, certain parathyroid glands may enlarge without such symptoms. Described here is a case in which a patient presented with acute signs of unilateral cervical point tenderness, dysphagia, and odynophagia. Calcium and parathyroid hormone levels tested within normal range. Imaging revealed an enlarged right-sided mass, with compression of the trachea-esophageal groove and potentially the right recurrent laryngeal nerve. Surgical excision was performed, and final pathology revealed an infarcted parathyroid adenoma. Clinical symptoms promptly resolved thereafter. Current NIH criteria for parathyroidectomy include various symptoms of hyperparathyroidism but do not include the above findings. Nonsecreting parathyroid adenomas rarely cause laryngeal symptoms, as this has only been documented once before.

scholarly journals Cerebral vasculopathy and strokes in a child with COVID-19 antibodies: illustrative case

2021 ◽  
Vol 2 (3) ◽  
Author(s):  
Chase H. Foster ◽  
Anthony J. Vargas ◽  
Elizabeth Wells ◽  
Robert F. Foster ◽  
Suresh N. Magge
Keyword(s):  
Case Report ◽  
Pediatric Patient ◽  
Pediatric Population ◽  
Preschool Age ◽  
Illustrative Case ◽  
Neurological Sequelae ◽  
Immune Mediated ◽  
International Data ◽  
Neurological Effects

BACKGROUND The ability of coronavirus disease 2019 (COVID-19) to cause neurological insults in afflicted adults is becoming increasingly understood by way of an ever-growing amount of international data. By contrast, the pandemic illness’s neurological effects in the pediatric population are both poorly understood and sparsely reported. OBSERVATIONS In this case, the authors reported their experience with a preschool-age child with hydrocephalus who suffered multiterritory strokes presumed secondary to immune-mediated cerebral vasculopathy as a result of asymptomatic COVID-19 infection. LESSONS Growing evidence indicates that COVID-19 can cause neurological sequelae such as encephalitis and strokes. In this case report, the authors discussed a case of cerebral vasculopathy and strokes in a pediatric patient who was positive for COVID-19.

scholarly journals Antiglomerular Basement Membrane Disease in a Pediatric Patient: A Case Report and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Vimal Master Sankar Raj ◽  
Diana Warnecke ◽  
Julia Roberts ◽  
Sarah Elhadi
Keyword(s):  
Renal Failure ◽  
Case Report ◽  
Basement Membrane ◽  
Rare Disease ◽  
Pediatric Patient ◽  
Clinical Features ◽  
Pediatric Population ◽  
Pulmonary Hemorrhage ◽  
Disease Entity ◽  
Review Of The Literature

Goodpasture’s syndrome (GPS) remains a very rare disease entity in the pediatric population characterized by the presence of pulmonary hemorrhage and rapidly evolving glomerulonephritis. We hereby describe the case of a 2-year-old girl who presented with renal failure and was diagnosed with GPS. A brief review of the literature in regard to data on demographics, pathogenesis, clinical features, diagnosis, treatment, and prognosis for renal recovery is also provided.

Valproic Acid Induced Thrombocytopenia and Dysmegakaryopoiesis in a Pediatric Patient

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S98-S98
Author(s):  
J Langlie ◽  
M Huberman ◽  
Y Akgun
Keyword(s):  
Bone Marrow ◽  
Valproic Acid ◽  
Case Report ◽  
Pediatric Patient ◽  
Complete Blood Count ◽  
Pediatric Population ◽  
Fatty Acid Derivative ◽  
Normal Female ◽  
Diagnostic Pitfall ◽  
High Level

Abstract Introduction/Objective Valproic acid is a branched short chain fatty acid derivative that is used primarily to treat epilepsy as well as mood disorders, certain types of headaches, and neuropathic pain. It is commonly prescribed in the pediatric population and has shown to be effective for refractory epilepsy with adequate seizure control. Serious side effects may be prominent if the medication is not kept at the therapeutic range. A wide variety of known hematologic problems can be encountered including but not limited to anemia, thrombocytopenia, and leukopenia. Methods/Case Report We present a case of a pediatric patient with a past medical history significant for history of seizure disorder and who presented to Jackson Memorial Hospital for intermittent fevers and multiple unexplained bruises for 3 weeks as well as fatigue and weakness.The patient was recently started on valproic acid. Complete blood count (CBC) was obtained and showed a platelet count of 23 x10(3)/mcL with WBC of 3.5 x10(3)/mcL and hemoglobin of 9.7 g/dL.Serum valproate concentration was critically high (154 mg/L). Trephine biopsy showed a normocellular marrow (60%) showing maturing trilineage hematopoiesis and scattered atypical megakaryopoiesis characterized by small forms that are seen in relatively loose interstitial clusters (Figure 1). The marrow aspirate smears were characterized by cellular spicules with dysmegakaryopoiesis including numerous small hypolobated forms with frequent forms showing separated nuclei (Figure 2, 3, and 4). Blasts did not appear increased, comprising overall 1% of marrow cellularity. Karyotype studies revealed a normal female karyotype, 46, XX. FISH studies using probes commonly detected in MDS were negative. Next generation sequencing was negative for AML specific mutations including GATA1 and GATA2 mutations. Results (if a Case Study enter NA) N/A Conclusion This case report highlights the significant hematologic adverse effects of valproic acid, specifically pancytopenia with dysmegakaryopoiesis, raising the clinical suspicion of potential myelodysplastic syndrome. Critically high level of valproic acid (154 mg/L) and normalization of CBC after the stoppage of the medication strongly suggests that valproic acid can cause severe bone marrow suppression and specific morphologic atypia in the megakaryocytic lineage thus introducing a potential diagnostic pitfall. Because the CBC returned to normal, bone marrow biopsy was not repeated.

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