HYPERPARATHYROIDISM DUE TO DIFFUSE HYPERPLASIA OF ALL PARATHYROID GLANDS RATHER THAN ADENOMA OF ONE

Abstract

The literature now contains over 100 cases of hyperparathyroidism proved by autopsy or operation. At the Massachusetts General Hospital we have studied 19 such cases. Our experience with the first 14 of these cases led us to believe that the pathologic basis of this condition is a functioning adenoma of one parathyroid gland, or possibly on rare occasions of two glands, with the remaining glands relatively normal (fig. 1).¹ The vast majority of the cases in the literature supported this belief. Cases 15, 16 and 17 in our series, however, demonstrate conclusively that the parathyroid pathologic process in some instances is entirely different, namely, a hyperplasia of all parathyroid tissue. This constitutes a different disease, which it is important to recognize and which requires different treatment. REPORT OF CASES Case 15. —A. P., a widow of 62, entered the hospital for the third time in November 1933, with the