Objective To report two rare cases of primary hyperparathyroidism (PHP) caused by single benign parathyroid adenoma.
Method The clinical case history biochemical findings, imaging result, and pathologic features of the resected adenomas are presented. The differential diagnosis of hypercalcemia and the genetic implication for both parathyroid adenomas and hyperplasia will be discussed.
Result Two male patients, 12 and 16 years of age, were evaluated for hypercalcemia. The 12-year-old boy had a history of intermittent hematuria and the 16-year-old's hypercalcemia was detected by routine laboratory evaluation for elective surgery. Biochemical findings in both cases were consistent with PHP. An imaging study in one case identified parathyroid adenoma, and the other case was nonconclusive. Both patients were found to have a single, benign parathyroid adenoma at surgery, which was successfully removed. Serum calcium parathyroid hormone normalized after surgery and continued to remain normal in subsequent follow-up clinic visit.
Conclusion Although relatively common in adults, parathyroid adenoma in children younger than 16 years of age is quite rare. The patient may have minimal symptoms or hypercalcemia may be an incidental finding. PHP in most children is caused by parathyroid adenoma. As opposed to adults, a male predominance of PHP is observed in children. Long-term biochemical follow-up of these patients is warranted.
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