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With a recent realization of screening serum Ca values determined, case reports on primary hyperparathyroidism are increasingly seen. Moreover, parathyroid carcinoma is becoming a concern as a causative factor for the disease, but its reports are seldom found.A 41-year-old woman visited our hospital with the chief complaints of pain of both the knee joints and lumbago. A solid tumor with a size of the head of index finger was palpated in the anterior cervical region. Serum Ca and parathyroid hormone (PTH) levels were as high as 17.8mg/dl and 8.2ng/ml, respectively. The patient was diagnosed as primary hyperparathyroidism and admitted. Preoperative fine aspiration biopsy revealed Class V. Lumpectomy and regional lymphnode excision were carried out under a diagnosis of parathyroid carcinoma, which was confirmed pathohistologically. No lymph node metastasis was observed. After surgery the serum Ca level rapidly decreased, and the patient was discharged.We presented a case of parathyroid carcinoma in which fine aspiration biopsy could successfully offer a definite diagnosis preoperatively.