
concurrence of hyperplasia and
neoplasia of the parathyroid glands
the concurrence of parathyroid hyperplasia
and neoplasia in a group of six patients is re-
ported.  two patients had long-standing renal
disease with azotemia and hyperphosphatemia.
in both hypercalcemia developed while they
were under observation and they were found to
have parathyroid adenomas as well as hyper-
plasia of the other glands.  a third patient
followed an apparently similar course.  one pa-
tient with primary hyperparathyroidism due to a
large mediastinal adenoma displayed hyper-
plasia of other glands in association with moder-
ate renal insufficiency.  two patients with pri-
mary generalized parathyroid hyperplasia were
found to have superimposed neoplastic lesions:
multiple adenomatous nodules in one, adenocar-
cinoma in the other.
these observations add new dimensions to the
diagnosis and therapy of parathyroid disorders.
they indicate the necessity of examining all four
parathyroid areas at time of surgery.  they also
emphasize that hypercalcemia developing in
patients with chronic renal disease is a manifesta-
tion of autonomous parathyroid function.
