There has been a great deal of controversy in recent years over the management of nontoxic nodular goiter. Many authorities have insisted that all such goiters should be extirpated because of the risk that they are, or might become, malignant.1-4 Some of them have claimed that as many as 15% of nontoxic nodular goiters are malignant.3,4 Others have pointed out that thyroid cancer is a rare disease, while nodular goiter is fairly common, and that figures such as the above, which are based on highly selected surgical statistics, are not applicable to the population as a whole.5-8 The true prevalence of malignancy in nontoxic nodular goiter has been estimated by these authors to be considerably less than 1%. Several authorities have concluded that routine removal of all nontoxic nodular goiters is not indicated, and would in fact cause a surgical morbidity and mortality which would outweigh the
SOKAL JE. A Long-Term Follow-Up of Nontoxic Nodular Goiter: Effect of Clinical Selection on the Observed Incidence of Malignancy. AMA Arch Intern Med. 1957;99(1):60–69. doi:10.1001/archinte.1957.00260010062009
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