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Sir, Progressive image technologies are improving the accuracy for determining the localization of enlarged parathyroid glands (PTGs) in hyperparathyroidism (HPT). However, the identification of an unusually located cervical nodule as an ectopic PTG remains uncertain. The measurement of parathyroid hormone (PTH) in the aspirated material with a fine needle has shed light on this diagnostic difficulty [1–4]. Here, we report two cases who developed recurrent renal HPT by ectopic PTGs after a long-term interval of ‘total’ parathyroidectomy (PTX).

Determination of parathyroid hormone levels in fine needle aspirates of ectopic parathyroid glands