Management of primary hyperparathyroidism in children

Primary hyperparathyroidism is unusual in children. It is most commonly due to a solitary sporadic parathyroid adenoma, though parathyroid hyperplasia and related familial syndromes should be considered. In the case presented here, an 11-year-old boy with primary hyperparathyroidism had preoperative imaging studies that localized to the inferior aspect of the left side of the neck anteriorly, and a parathyroid adenoma was successfully resected. Screening for familial syndromes involving hyperparathyroidism should be individually considered in children with primary hyperparathyroidism. Preoperative localizing studies and the role of unilateral surgery are controversial issues in adults with primary hyperparathyroidism. Although such issues have not been addressed in children, localization and unilateral surgery proved successful in this case.