There are generally four normal parathyroid glands, which “hide” in the neck in small glands about 1*2*3 mm, or the size of a “green bean”, behind the upper and lower extremities of the left and right lobes of the thyroid gland. Even in the case of adenomas (more than 85%), hyperplastic lesions, or even the rare parathyroid cancer, it is difficult to feel them. However, a compound secreted by the parathyroid glands, namely parathyroid hormone (PTH), affects calcium and phosphorus metabolism through blood circulation to target organs throughout the body, leading to bone decalcification and bone destruction, causing painful osteoporosis, easy fractures, bone cysts, and short stature, etc. Increased blood calcium leads to increased urinary calcium, causing kidney calcification and persistent kidney stones. There are also non-specific symptoms caused by hypercalcemia such as insomnia, constipation, and even hypercalcemic coma. Parathyroid lesions are small, deeply located, and have a low incidence, producing symptoms or manifestations that are multidisciplinary, “distant,” and nonspecific, and can easily be misdiagnosed, but in fact are not harmful in themselves. In one case this year, a senior male had a hip replacement due to bilateral femoral neck fractures, and was diagnosed with a parathyroid adenoma during casual conversation, which treated both the symptoms and the root cause. In the other two cases, middle-aged men with kidney stones had two or more extracorporeal shock wave lithotripsy and minimally invasive surgery on one side to remove the stones, but still had kidney stones. “A parathyroid tumor of the size of a peanut rice was removed, and a lithotripsy soup was taken to “treat both the symptoms and the root cause. In another female patient, because of a bone “tumor”, elevated blood calcium was found in a routine preoperative blood test. After neck ultrasound and specific parathyroid nuclide imaging, a secondary bone cyst (“brown tumor”) caused by a parathyroid adenoma was considered. With the removal of the parathyroid lesion and postoperative calcium supplementation, the bone cyst “self-healed” after a period of time, avoiding misdiagnosis and mistreatment. In view of the atypical symptoms of primary hyperparathyroidism, accurate qualitative localization is performed by clinical laboratory (preoperative and postoperative laboratory tests and intraoperative rapid PTH testing) and nuclear medicine parathyroid imaging (technetium MIBI, or SPECT-CT stereoscopic imaging, the gold standard). Minimally invasive and precise surgery is then performed in our thyroid surgery department.