22 patients with hyperplasia and adenomas of the parathyroid glands were studied and reviewed. They form the basis of this report, which emphasizes the idiosyncracies and vagaries of this disease. The diagnosis of hyperparathyroidism is reported in context with the clinical picture, and the overall relationship of this condition to multiple endocrine adenomatosis is explored in some depth. A specific patient review is made which illustrates the odd clinical behavior of parathyroid hyperfunction; 3 patients with cancers are studied in detail. Surgical management is discussed and concentrates on the more vexing aspects of parathyroid identification, adenomas vs. hyperplasia, recurrent disease and cancer.
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