Enlarged cystic parathyroid glands, whether hyperfunctioning or nonfun
ctioning, are rare and their accurate preoperative diagnosis is a diff
icult task. The authors report two cases of patients with cystic neck
masses studied by Tl-201-Tc-99m pertechnetate subtraction scintigraphy
, computerized tomography, and ultrasonography. The diagnostic consens
us of preoperative studies was that these lesions were thyroid nodules
or parathyroid adenomas. Surgical removal and histopathologic examina
tion of these masses revealed a cystic parathyroid gland and a cystic
parathyroid adenoma, respectively. When a fluid-filled lesion in the n
eck deep to the lower pole of the thyroid gland is encountered, the po
ssibility of a parathyroid cyst should be considered so that further d
iagnostic tests can be properly performed.