The article by Cantalamessa and colleagues1 points out that thyroid nodules occur with a high frequency in patients with Graves disease as determined by ultrasonography and pathological examination findings. Nevertheless, the authors discovered only 1 case of carcinoma among 315 consecutive patients (0.3%), including 106 with nodules. Surprisingly, this is a rather low frequency compared with previous studies and the findings from a recent series.2 We assume that this low frequency is the result of the fact that only 20 patients underwent surgery.