Ectopic parathyroid adenomas are one of the causes of failed neck expl
oration for primary hyperthyroidism. Location of the ectopic gland in
the pyriform recess is rarely described premortem. Moreover, removal o
f such an ectopically located gland using an endoscopic approach, ther
eby avoiding potentially morbid repealed open neck explorations, to ou
r knowledge, has not been described.