The authors described a case of chronic hyperplastic parathyroiditis with hyperparathyroidism occurred in a patient undergone to surgery for laryngeal carcinoma. The morphological picture, the clinical date and the review of the previous studies suggest some hypothesis about the pathogenesis of the chronic hyperplastic parathyroiditis: parainfectious origin, anomalous embryonal development, environmental factors and autoimmune process are considered. The latter pathogenetic mechanism is likely to be involved in most of cases.