Snapshot A 45-year-old woman presents with pain and achiness in her joints and bones, as well as confusion and a dulled mental state. She also has had recurrent episodes of kidney stones, and in the ED they found QTc shortening on her EKG. She is currently requesting morphine for her GI pain. Introduction Associated with MEN I (parathyroid, pancreatic tumor, pituitary adenoma) and IIa (medullary carcinoma of the thyroid, pheochromocytoma, hyperplasia of the parathyroid) login to view 1 more bullet Right inferior gland is most common location login to view 1 more bullet Carcinoma is rare Presentation Symptoms login to view 2 more bullets Evaluation Histology login to view 2 more bullets Serology login to view 2 more bullets Technetium-99m-sestamibi radionuclide scan login to view 1 more bullet Treatment Surgical login to view 8 more bullets Acute hypercalcemia login to view 4 more bullets