It is commonly held that exophthalmic goiter and toxic adenoma are two separate diseases. The distinction between these two diseases seems to be based, in part at least, on a consideration of differences in (1) clinical manifestations, (2) anatomic and histologic alterations in the thyroid and (3) the response to iodine therapy. It is my purpose to discuss the foregoing considerations only as they have a direct bearing on the proposition that exophthalmic goiter and toxic adenoma are two fundamental entities.
—There is very little difficulty in recognizing, clinically, cases of classic exophthalmic goiter; the symptoms and signs are too well known to require repetition.More important in the present discussion are the less typical cases (without adenomatous thyroids) in which there is historical or physical evidence of long standing disability. In such cases there may be questionable eye signs, including exophthalmos; there may be alterations
GRAHAM A. EXOPHTHALMIC GOITER AND TOXIC ADENOMA: CLINICAL VARIATIONS OF A SINGLE DISEASE. JAMA. 1926;87(9):628–631. doi:10.1001/jama.1926.02680090006003
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