{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T10:39:32Z","timestamp":1787740772190,"version":"build-2784847793"},"reference-count":34,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary hyperparathyroidism (PHPT) in children and adolescents is uncommon. Data\u2010driven guidelines for management in pediatric patients are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective cohort analysis of all patients (1997\u20132017) with PHPT\u2009\u2264\u200921 years of age who underwent parathyroidectomy at three institutions. Clinical and demographic variables were analyzed. Primary operative outcome was cure (normocalcemia\u2009&gt;\u20096\u00a0months after surgery); secondary outcome was operative success (intraoperative parathyroid hormone decrease of\u2009\u2265\u200950%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 86 patients with a median age of 17 years (IQR: 14, 19); 64% (<jats:italic>n<\/jats:italic>\u2009=\u200955) were female. The mean preoperative serum calcium was 11.7\u00a0mg\/dL, median parathyroid hormone (PTH) was 110 pg\/mL, and median urine calcium was 4.1\u00a0mg\/kg\/24 h. Preoperatively, sestamibi scan localized in 41\/71 patients (58%); neck ultrasound localized in 19\/44 (43%). The most common pathology at surgery was a single ectopic parathyroid adenoma in 71% (<jats:italic>n<\/jats:italic>\u2009=\u200961). A high incidence of ectopic adenomas (25%, <jats:italic>n<\/jats:italic>\u2009=\u200922) was observed, most commonly intrathymic (<jats:italic>n<\/jats:italic>\u2009=\u200913), followed by tracheoesophageal groove (<jats:italic>n<\/jats:italic>\u2009=\u20095), carotid sheath (<jats:italic>n<\/jats:italic>\u2009=\u20092), and intrathyroidal (<jats:italic>n<\/jats:italic>\u2009=\u20092). Of 56 patients with retrievable data\u2009&gt;\u20096\u00a0months postoperatively, cure was achieved in 55 of 56 patients (98%). One patient who presented to us with parathyromatosis require subsequent reoperation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this multi\u2010institutional series of PHPT in children and adolescents, the majority were sporadic PHPT and were due to a single adenoma. We observed a high incidence of ectopic parathyroid adenomas, most commonly intrathymic. Given the high risk for ectopic adenoma in pediatric patients, parathyroid surgery in children and adolescents should be performed by experienced surgeons.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-019-05362-8","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T16:03:05Z","timestamp":1578067385000},"page":"1518-1525","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":24,"title":["Single Gland, Ectopic Location: Adenomas are Common Causes of Primary Hyperparathyroidism in Children and Adolescents"],"prefix":"10.1002","volume":"44","author":[{"given":"Robert D.","family":"Rampp","sequence":"first","affiliation":[{"name":"Department of Surgery University of Tennessee Health Sciences Center Chattanooga TN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edna E.","family":"Mancilla","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Children's Hospital of Philadelphia Philadelphia PA USA"},{"name":"Perelman School of Medicine University of Pennsylvania Philadelphia PA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N. 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Institutional Review Board approval was received for the conduct of this research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}