NODULAR GOITER AND MALIGNANT LESIONS OF THE THYROID GLAND*

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Abstract
The malignant lesions of the thyroid gland seen at the Mayo Clinic from 1938 to 1947, inclusive, differed from those seen prior to 1938 in that the incidence of papillary adenocarcinoma increased from 30 to 60%, that of carcinoma in an adenoma decreased by more than half, and that of diffuse adenocarcinoma decreased by more than a third. Carcinoma was found in 4.8% of a series of more than 5500 cases in which a nodular goiter was treated surgically. It was found in 7.5% of more than 3000 cases in which thyroidec-tomy was performed because of adenomatous goiter without hyperthyroidism. A carcinoma, unsuspected on clinical examination, was found in 3.8% of the cases. Carcinoma was found in approximately 1.0% of more than 2000 cases of adenomatous goiter with hyperthyroidism, and in 0.5% of the 3000 cases of exophthalmic goiter. In the series of 276 cases of carcinoma, approx. half of the papillary lesions, two thirds of the malignant adenomas, and a fifth of the diffuse adenocarcinomas were not suspected on clinical examination.

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