A Diagnosis of Normocalcemic Primary Hyperparathyroidism Prompted by "Salt and Pepper" Lesions of the Calvarium.

Background: We report a case of normocalcemic primary hyperparathyroidism, a diagnosis prompted by radiographic "salt and pepper" calvarial lesions, typically described in hypercalcemic primary hyperparathyroidism or secondary hyperparathyroidism.

Case Report: A 60-year-old woman noticed indentations of her scalp and presented to her primary care provider. Radiography of the calvarium demonstrated granular "salt and pepper" lesions, prompting investigation.