Due to the rarity of this disease, clinicians need to have a high index of suspicion and consider parathyroid carcinoma in the differential diagnosis of primary hyperparathyroidism, especially in the presence of a palpable mass or atypical imaging findings associated with a high level of PTH and hypercalcemia over 14 mg/dL. This evidence concerns the gene PTH and parathyroid gland carcinoma.