Single gland adenoma is the most common cause of primary hyperparathyroidism (PHPT). Although PHPT is generally an asymptomatic disease detected by an incidental finding of hypercalcemia, overt skeletal disease, renal failure and huge adenoma that cause local pressure can be seen seldomly in neglected cases. We report a case of a parathyroid adenoma weighing 116 g (normal weight 25 - 40 mgs)causing multiple brown tumors, renal failure and refractory anemia.
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