Our patient had serum calcium of 23.2 mg/dL which is amongst the highest reported with parathyroid carcinomas/adenomas as per our knowledge right after Hauwe et al, which was due to an adenoma [8] and a couple of other cases due to PTHrP where calcium levels were 23.6 mg/dL [9]. This evidence concerns the gene PTHLH and parathyroid gland carcinoma.