What Thyroid Nodules Are to Be Feared?*†

Thyroid cancer: Twenty years' experience in a general hospital

“…If total lobectomy is regarded as the minimal surgical procedure for the solitary nodule, then, it has been argued, total thyroidectomy must be the prophylaxis for multinodular goitre (Cope et al, 1949). Lesser procedures may in theory have resulted in local dissemination of carcinoma in 12.8 per cent of the patients seen in this series.…”

“…The incidence of carcinoma in non-toxic multinodular goitre amongst the general population is much lower than that seen surgically. Carcinoma incidences of 10 per cent (Cope et al, 1949), 10.9 p: r cent (Crile and Dempsey, 1949) and 17.1 per cent (Cole et al, 1949) have previously been reported in excised non-toxic multinodular goitres.…”

Carcinoma of the Thyroid Gland*

“…We recommend bilateral subtotal thyroidectomy. Cope (19) is of the same opinion. Crile (12) objects to the routine removal of multinodular goiter in goiter-belt areas.…”

“…In a group reported by Pemberton and associates (6,18), carcinoma was not suspected in 60 per cent. Cope and associates (19) have reported the importance of the Delphian or cricoid lymph node as an indication of metastatic thyroid cancer. TREATMENT Because of the high incidence (20.9 per cent) of carcinoma in solitary nontoxic nodular goiter we recommend total thyroid lobectomy of the involved side including the isthmus, assuming that the other side is normal b}' actual surgical exploration.…”

The management of thryroid swellings

“…The policy towards cold solid nodules is to arrive at a tissue diagnosis. Anything between 7 and 20 per cent of cold nodules are carcinomatous (Shukri, 1967;Cope et al, 1949) and if the results of treating cancer of the thyroid are to be improved, a more energetic and conscientious approach to the management of solitary nodules is desirable.…”