Enlargement of the parathyroid glands has been noted in numerous instances in the course of postmortem examinations. In animals it has been produced experimentally in association with rickets, and in the human being it has been found in patients with abnormal conditions of the osseous system. The enlargement has been considered as an attempt of the body to compensate for the disturbance of calcium metabolism.
In 1926, Mandi1 postulated that in some instances the parathyroid enlargement was primary and that the bone changes arose secondary to hyperparathyroidism. Having failed to obtain relief for a patient with generalized osteitis fibrosa by means of parathyroid transplants or injections of parathyroid extract, he performed an exploratory operation and found one of the parathyroids definitely enlarged. This was removed and found to be adenomatous. Following its removal, the patient improved steadily. Gold,2 in 1928, and Barr,3 in 1929, reported similar instances.