A common etiology of hypercalcemia is Primary Hyperparathyroidism. Eighty percent of the time a single adenoma is present. Labs usually show an elevated Parathyroid hormone. Head and neck US, Sestamibi and CT scanning are important for localization. In our case, diagnostic results suggested a right lower pole location for a parathyroid adenoma. Referral to General Surgery was made for focused neck dissection. Bilateral neck exploration was required as only three glands were identified. After exploration of possible ectopic inferior gland locations, a right thyroid lobectomy was performed. This ectopic location was confirmed via intraoperative serial PTH measurements. This case illustrates a rare ectopic location for a parathyroid adenoma.

Keywords: Hypercalcemia; Primary hyperparathyroidism; Ectopic parathyroid adenomas