NONENCAPSULATED SCLEROSING TUMORS OF THE THYROID*

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Abstract
AS early as 1927, Allen Graham (1) recognized the existence of a circumscribed but not encapsulated tumor of the thyroid which he designated as an adenocarcinoma not originating in an adenoma. Though he did not publish the cases in detail, his diagnosis of such lesions in the pathologic files of the Cleveland Clinic continues consistently from that date. Early in his studies of these tumors he recognized their particular nature and relative innocence. In pathologic reports he would often note that though malignancy was indicated by local invasion of stroma and adjoining thyroid there was no invasion of blood vessels and the prognosis was good. He twice observed these small tumors in thyroids removed at autopsy and found many of them incidentally in thyroids removed surgically for various reasons. In no case was the presence of the tumor suspected prior to operation or autopsy. This report deals with 25 of these small, nonencapsulated tumors of the thyroid occurring between the years 1928 and 1941 at the Cleveland Clinic, emphasizes their particular nature and suggests that, until more is known of their natural history, they should not be regarded as true carcinoma.

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