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Background: Spontaneous rupture of tendon is a rare disease that often occurs following an underlying disease or drug usage. However, the association of this condition with primary hyperparathyroidism has rarely been reported. Case: In a case-study, two cases of spontaneous tendon rupture associated with primary hyperparathyroidism are reviewed. The first one is a middle-aged woman that due to bilateral patellar tendon rupture is operated for secondary repair and augmentation of tendons. The second one is a middle-aged man with unilateral triceps brachii tendon rupture who has been operated for primary tendon repair. Conclusion: Since paramount force is needed for tendon rupture, in spontaneous tendon rupture cases, patient evaluation for detecting underlying diseases and drug usage is necessary. In cases that the history of an underlying disease is not indicated, evaluation of serum level concentrations of Ca, P, ALP, and PTH is recommended for contraindication of primary hyperparathyroidism.

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Background: Localization of ectopic parathyroid glands is one of the most sophisticated challenges in endocrine surgery and there is considerable controversy regarding the suitable approach to localize ectopic parathyroid glands and indications for using different modalities. The failure of the first operation leads to pain, scar, and financial burden of the following operation. Case: The patient was a 39-year-old woman hospitalized with hematuria as the main complaint and noticing the presentation of hypercalcemia in the initial tests underwent more thorough examination. Ultrasonography and 99mTc sestamibi scan helped us to localize the ectopic parathyroid gland in an anterior mediastinum and treat the patient in a one stage operation. Conclusion: Paying careful attention to the symptoms and signs, considering all differential diagnoses, and using appropriate diagnostic methods can be helpful in the diagnosis of rare syndromes.