Parathyroid carcinoma is a very rare cause of primary hyperparathyroidism. Pre-operative diagnosis remains a challenge. We report a case referred for a suspicious goiter with a poor general condition associated with hypercalcemia. Cytological findings attributed it to a possible parathyroid neoplasm that must be considered in the differential diagnosis of a nodular thyroid mass by the cytopathologist. Serum parathormone levels were correlated and the patient underwent surgery. Histopathology confirmed the diagnosis of parathyroid carcinoma. There can be a major pitfall, as it may appear indistinguishable from a benign adenoma.
Keywords: Hypercalcemia; hyperparathyroidism; parathyroid carcinoma.