Reitz RJ, Dreimiller A, Khil A, et al. - In this study, the rate of ectopic and supernumerary parathyroid glands and the outcome of surgical therapy were ascertained in patients with refractory renal hyperparathyroidism. Researchers conducted a retrospective review of all patients who had undergone parathyroidectomy for refractory renal hyperparathyroidism. They reviewed operative and pathology reports and ascertained the number and location of resected parathyroid glands, patient outcomes, and follow-up. The analysis included a total of 68 patients who had undergone subtotal or total parathyroidectomy for renal hyperparathyroidism during the period 1993–2019. It was shown that ectopic and supernumerary parathyroid glands occurred in 26% and 16% of patients with renal hyperparathyroidism, respectively, and the thymus was the most common location. For renal hyperparathyroidism, thorough neck exploration and transcervical thymectomy are important to help reduce persistent and recurrent hyperparathyroidism after parathyroidectomy.