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October 14, 1974

Hyperparathyroidism Monograph

JAMA. 1974;230(2):210-211. doi:10.1001/jama.1974.03240020018010

To the Editor.—  We believe that Drs. Oliver Cope and Leon Goldman in their review of our modern surgical monograph Hyperparathyroidism (228:1038, 1974) exceeded the usual and customary boundaries. To balance a partisan attack and to maintain better perspective, we offer this rebuttal.The reviewers seemed not to appreciate that the findings in patients who underwent surgery for hyperparathyroidism in this decade differ greatly from those found in the pioneering days of parathyroid surgery. Appropriately revised endocrine surgery is not restricted to parathyroid disease either.Adenomatous hyperplasia is a diffuse process that involves, at some stage, the entire gland. This concept was proposed by Erdheim in 1907, and espoused by Albright and Reifenstein in 1948, and by Dr. Cope in 1966. Many reports have noted the diffuse hyperplastic process in the Zollinger-Ellison syndrome, in pituitary tumors, in Cushing disease, in medullary thyroid cancer, in Graves disease, and in hyperparathyroidism, whether