title: Giant parathyroid adenoma associated with severe hypercalcemia in an adolescent patient.
abstract: BACKGROUND
  The objective of this study is to bring attention to the importance of differential diagnosis in adolescent patients with skeletal involvement and hypercalcemia.
  
  
  METHODS
  A 17-year-old male patient with a complaint of severe leg pain was admitted to our hospital. Seven months before he had a fracture of his distal humerus after falling on to his left shoulder and was treated conservatively. Five months previously, he had a rupture of his quadriceps tendon. Magnetic resonance imaging (MRI) was performed for the quadriceps tendon rupture and was evaluated as polyostotic fibrous dysplasia (PFD). Doctors decided to operate for the ruptured tendon but they detected severe hypercalcemia in the pre-operative blood tests and noticed that the main disease was primary hyper-parathyroidisim (PHPT) which was caused by a giant parathyroid adenoma. Conclusions Giant parathyroid adenoma can present in adolescent patients with multiple bone lesions and severe hypercalcemia. PHPT should be considered in the differential diagnosis of pathological bone fractures and benign bone tumors in every age. This may prevent patients from miss or delayed diagnosis of PHPT.
authors.affiliation: Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi cad. Etfal Sk. 34371, Sisli, Istanbul.
authors.forename: Kinyas
authors.identifier: http://orcid.org/0000-0002-3338-363X
authors.initials: K
authors.lastname: Kartal
authors.affiliation: Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul.
authors.forename: Nurcihan
authors.initials: N
authors.lastname: Aygun
authors.affiliation: Department of Radiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul.
authors.forename: Mujdat
authors.initials: M
authors.lastname: Bankaoglu
authors.affiliation: Department of Radiology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul.
authors.forename: Alper
authors.initials: A
authors.lastname: Ozel
authors.affiliation: Department of General Surgery, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Uludag
mesh_terms: D000236:Adenoma / Q000150:complications*; D000293:Adolescent; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D008297:Male; D010282:Parathyroid Neoplasms / Q000150:complications*; D012720:Severity of Illness Index
keywords: adolescence; giant parathyroid adenoma; malignant hypercalcemia; osteitis fibrosa cystica