[Summary] A case of primary hyperparathyroidism ( PHPT ) complicated with Graves′disease was reported.The parathyroid lesion( s) could not be identified by repeated MIBI and ultrasonography tests.With the control of hyperthyroidism, medical therapies of hypercalcemia were still not effective, the serum calcium levels continued to be high.Thus, the decision to operate was made.The pathological findings confirmed the diagnosis of parathyroid adenoma.For PHPT patients with clear surgical indications, even though the pre-operative localizing tests are negative, operation is still worth to try.
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