Stone in the Neck with Stones, Moans and Groans

Parathyroid carcinoma is a rare cause of Primary Hyperparathyroidism and this endocrine tumor may be aggressive or indolent. This disease is an enigma and there are challenges in diagnosis, management and adjuvant treatment and the endocrine surgeon should have a high index of suspicion based on clinical findings and investigationsin the form of very high parathyroid hormone levels, hard tumour, large tumour, severe hypercalcemia, compressive symptoms and ultrasound or imaging features suggestive of parathyroid carcinoma which is the key to preoperative diagnosis and appropriate and intraoperative managent and we report a classical case of parathyroid carcinoma with Hyperparthyroidism induced hypercalcemic crisis and classical pathological findings.