Adjacent to this parathyroid adenoma at the left is a rim of normal parathyroid. Patients with this form of primary hyperparathyroidism are usually diagnosed with routine chemistry panels in which a high serum calcium is noted, though some may present with renal stones, bone pain, headaches, gallstones, pancreatitis, or gastric ulcers. A parathormone (PTH) assay reveals a high normal to elevated level of PTH.