Multiple adenomas of the parathyroids: do they exist?

Since Cope's original description of chief cell hyperplasia in 1958, there has been general agreement that this entity is the most common cause of multiple parathyroid enlargement. Whether or not multiple adenomas of the parathyroid glands ever occur has been seriously questioned. Criteria are proposed for defining the entity of multiple parathyroid adenomas in contrast with hyperplasia. With the use of these criteria, five patients with multiple adenomas were found in our last 300 cases of primary hyperparathyroidism.