{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:24:28Z","timestamp":1790079868383,"version":"4.0.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,1,2]],"date-time":"2020-01-02T00:00:00Z","timestamp":1577923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["asbmr.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JBMR Plus"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Primary hyperparathyroidism is a condition that occurs infrequently in children. Parathyroid carcinoma, as the underlying cause of hyperparathyroidism in this age group, is extraordinarily rare, with only a few cases reported in the literature. We present a 13\u2010year\u2010old boy with musculoskeletal pain who was found to have brown tumors from primary hyperparathyroidism caused by parafibromin\u2010immunodeficient parathyroid carcinoma. Our patient had no clinical, biochemical, or radiographic evidence of pituitary adenomas, pancreatic tumors, thyroid tumors, pheochromocytoma, jaw tumors, renal abnormalities, or testicular lesions. Germline testing for\n                    <jats:italic>AP2S1<\/jats:italic>\n                    ,\n                    <jats:italic>CASR<\/jats:italic>\n                    ,\n                    <jats:italic>CDC73\/HRPT2<\/jats:italic>\n                    ,\n                    <jats:italic>CDKN1B<\/jats:italic>\n                    ,\n                    <jats:italic>GNA11<\/jats:italic>\n                    ,\n                    <jats:italic>MEN1, PTH1R<\/jats:italic>\n                    ,\n                    <jats:italic>RET,<\/jats:italic>\n                    and the\n                    <jats:italic>GCM2<\/jats:italic>\n                    gene showed no pathological variants, and a microarray of\n                    <jats:italic>CDC73\/HRPT2<\/jats:italic>\n                    did not reveal deletion or duplication. He was managed with i.v. fluids, calcitonin, pamidronate, and denosumab prior to surgery to stabilize hypercalcemia. After removal of a single parathyroid tumor, he developed severe hungry bone syndrome and required 3\u2009weeks of continuous i.v. calcium infusion, in addition to oral calcium and activated vitamin D. Histopathological examination identified an angioinvasive parathyroid carcinoma with global loss of parafibromin (protein encoded by\n                    <jats:italic>CDC73\/HRPT2<\/jats:italic>\n                    )\n                    <jats:italic>.<\/jats:italic>\n                    HRpQCT and DXA studies were obtained prior to surgery and 18\u2010months postsurgery. HRpQCT showed a resolution of osteolytic lesions combined with structural improvement of cortical porosity and an increase in both cortical thickness and density compared with levels prior to treatment. These findings highlight the added value of HRpQCT in primary hyperparathyroidism. In addition to our case, we have provided a review of the published cases of parathyroid cancer in children. \u00a9 2019 The Authors.\n                    <jats:italic>JBMR Plus<\/jats:italic>\n                    published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.\n                  <\/jats:p>","DOI":"10.1002\/jbm4.10324","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T14:28:18Z","timestamp":1576247298000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Severe Primary Hyperparathyroidism Caused by Parathyroid Carcinoma in a 13\u2010Year\u2010Old Child; Novel Findings From HRpQCT"],"prefix":"10.1093","volume":"4","author":[{"given":"Nina","family":"Lenherr\u2010Taube","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Endocrinology  Toronto Canada"},{"name":"University of Toronto  Toronto 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