Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report

Abstract

Background: Primary hyperparathyroidism may present in various ways, from asymptomatic biochemical findings to gastrointestinal, psychiatric, renal, and bone manifestations. Though rare in pediatrics, timely diagnosis and management of hypercalcemia in children is critical for general pediatricians.

Case presentation: A 14-year-old male presented with vomiting, constipation, abdominal pain, and lethargy, with an elevated corrected calcium level of 4.3 mmol/L. Imaging revealed a large pelvic lytic lesion consistent with a brown tumor caused by primary hyperparathyroidism. Treatment included intravenous saline, bisphosphonates, and calcitonin for hypercalcemia stabilization, followed by parathyroidectomy. The post-operative period involved hungry bone syndrome. Long-term follow-up showed complete resolution of the lesion and normalized calcium levels.

Conclusions: This case underscores the importance for pediatricians to consider hypercalcemia in symptomatic children and highlights the first reported pediatric pelvic brown tumor. Prompt diagnosis and appropriate management can prevent severe multi-system complications of hyperparathyroidism.

Citation recommandée : Legault, O., Inman, M., Moolman, N., Nour, M. A., et al. (2020). "Severe hypercalcemia and a pelvic brown tumor in an adolescent with primary hyperparathyroidism: a case report." BMC Pediatrics. 20(1).
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