Thyroid Nodules Occurring Late After Treatment of Thyrotoxicosis with Radioiodine*

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Abstract
Among 256 patients with toxic diffuse goiter treated with radioiodine between 1946 and 1953, there were 8 patients in whom thyroid nodules developed between 5 and 14 years after the I131 therapy. Thyroidectomy in each of the 8 patients showed multiple nodules as well as effects attributable to irradiation. The frequency of occurrence of the late nodules was much higher in the younger patients, the highest frequency being in those less than 20 years of age at the time of treatment. These nodules appeared to originate in hyperplastic regenerating areas of thyroid epithelium and were thought to be due to a stimulatory effect of thyrotropin acting on thyroid tissue still capable of proliferating despite injury by irradiation. Development of the thyroid nodules or adenomas in the 8 patients closely paralleled the development of nodules as described in irradiated rat thyroids. Except for a single invasive adenoma in 1 patient, there was no evidence of malignancy in these human thyroid glands.

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