Primary hyperparathyroidism is the third most common endocrine disorder (0.4-82 cases per 100 000) that usually results from the presence of a single adenoma (80%) or multigland hyperplasia (15%-20%).1,2 The curative treatment consists of surgical removal of the affected parathyroid gland(s). Because parathyroid tissue may have great variability in anatomic location (along the embryological migration pattern from the base of tongue to mediastinum), preoperative localization studies and clinical experience play a fundamental role in surgical planning.