Parathyroid glands are occasionally found in an ectopic location. The vast majority of ectopic parathyroid glands are found within the thymus, in the anterior mediastinum, followed by the posterior mediastinum, thyroid and, rarely, the carotid sheath. Other rare sites of ectopy include the pericardium, vagus nerve or the soft tissue adjacent to the angle of the jaw. Parathyroid adenomas can occur in any site containing ectopic parathyroid tissue. Ectopic parathyroid adenomas may also be the cause of primary hyperparathyroidism. The concomitant existence of intrathyroidal parathyroid adenoma and papillary carcinoma of the thyroid is exceedingly rare. Here we report a case of intrathyroidal parathyroid adenoma associated with a synchronous micropapillary carcinoma in a 76-year-old female patient.