The serum parathormone of the patient was 796.7 Pg/mL. The patient had neck scintigraphy that revealed right parathyroid uptake. She underwent complete surgical resection and histopathological confirmation of parathyroid adenoma.

Sections prepared revealed well-circumscribed nodule with thin fibrous capsule formed mainly of nodules of clear cells with well-defined cell borders and rounded nuclei with no atypia or pleomorphism. Final diagnosis: parathyroid adenoma (clear cell type).

The main radiological sign of hyperparathyroidism is bone resorption with diffuse osteopenia.

Considering the patient's age, the first differential diagnosis of this case was metastasis followed by other lytic bone lesions causes.