title: Parathyroid Cancer in the Pediatric Patient.
abstract: BACKGROUND
  Parathyroid carcinoma is exceedingly rare in children. We describe a case of parathyroid cancer in a young female who was originally classified as benign and managed surgically. Upon her diagnosis with malignancy, concurrent with metastatic lung involvement, she was referred for medical and surgical palliation to control her symptomatic hypercalcemia. We briefly review published childhood cases, consider the challenges in differentiating malignant from benign hyperparathyroidism in this age group, and discuss the association of CDC73 mutations with parathyroid carcinoma.
  
  
  METHODS
  A 13-year-old African American girl with a history of parathyroid adenoma, diagnosed at 8 years of age with multiple recurrences, presented with hypercalcemia and elevated parathyroid hormone when her disease had been reclassified as malignant. Germline gene analysis revealed a heterozygous partial deletion of CDC73. The patient underwent palliative surgery for disease metastatic to her lungs. She continues with medical management of her hypercalcemia.
  
  
  CONCLUSIONS
  A case of pediatric parathyroid carcinoma associated with haploinsufficiency of CDC73 is discussed. We review all published cases of pediatric parathyroid carcinoma and offer diagnostic considerations for a parathyroid mass in a child.
authors.affiliation: *Department of Pediatrics, Le Bonheur Children's Hospital, University of Tennessee Health Sciences Center Departments of †Oncology ‡Pathology, St Jude Children's Research Hospital, Memphis, TN.
authors.forename: Jesse T
authors.initials: JT
authors.lastname: Davidson
authors.forename: Catherine G
authors.initials: CG
authors.lastname: Lam
authors.forename: Rose B
authors.initials: RB
authors.lastname: McGee
authors.forename: Armita
authors.initials: A
authors.lastname: Bahrami
authors.forename: Alicia
authors.initials: A
authors.lastname: Diaz-Thomas
mesh_terms: D000236:Adenoma / Q000235:genetics / Q000473:pathology*; D000293:Adolescent; D002277:Carcinoma / Q000235:genetics / Q000473:pathology*; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D010282:Parathyroid Neoplasms / Q000235:genetics / Q000473:pathology*; D025521:Tumor Suppressor Proteins / Q000235:genetics
chemical_list: C454900:CDC73 protein, human; D025521:Tumor Suppressor Proteins