In front of this large mass, the severe hypercalcemia and the very high level of PTH, the malignancy was suspected, and we completed the exploration by dosing two biomarkers of malignancy usually found in the parathyroid carcinoma, the alkaline phosphatase (ALP) which was at 420 UI/L [44–147 UI/L] (3 fold normal level) and the βHCG was in the upper limit of the normal range at 4.09 mUI/ml (<5 mUI/ml). Here, PTH is linked to hypercalcemia disease.