Symptom severity correlates with calcium levels and mass weight so that, although the most likely scenario is of an incidental diagnosis, malignancy or giant adenomas (defined by weight >3.5g or diameter >2cm), can trigger life-threatening hypercalcemic crisis [3-6]. The parathyroid crisis is rare and is characterized by extremely high levels of PTH, associated with severe hypercalcemia of acute onset, triggering multiorgan dysfunction (metabolic encephalopathy, renal failure, gastrointestinal symptoms, and cardiac arrhythmia) [6]. Here, PTH is linked to acute kidney injury.