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March 1968

The Autonomous Functioning Thyroid Nodule: Therapeutic Considerations

Author Affiliations

From the departments of endocrinology and general surgery, Henry Ford Hospital, Detroit.

Arch Surg. 1968;96(3):386-393. doi:10.1001/archsurg.1968.01330210064011

THE radioactive iodine scintigram will identify a minority of clinically evident thyroid nodules as functional to a greater degree than the surrounding follicular tissue. The management of such lesions requires that special consideration be given to two observations. First, the functioning nodule itself, as defined below, has correlated to date with a benign histological pattern,1 and second, its secretory activity may or may not produce a hyperthyroid state.2 In our experience, acknowledgement of the foregoing has raised the question not only of whether surgical removal is still the treatment of choice, but also if at any given time any treatment is necessary. The purpose of this report is to attempt to answer both questions insofar as our current knowledge enables us to do so.

Characteristics of the Functioning Autonomous Nodule  Relating an in vivo nodule to specific benign histologic characteristics requires precise evaluation. The nodule must be shown