OF THE ORIGIN, CHARACTERISTICS AND BEHAVIOR OF THYROID CANCER*

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Abstract
Clinical and pathological study of thyroid cancer from che experience of the Surgical Service of the Presbyterian Hospital, N.Y.C Examination of malignant thyroid glands shows no associated pathological conditions in over half the cases lending weight to the current concept that solitary nodules should arouse suspicion of malignancy. Although cancers are frequently found associated with benign neoplasms (true adenomas), there is little evidence of an etiological relationship between the two A cancer is probably a cancer from the beginning and not a transformation from a benign lesion. Degree of malignancy: (invasiveness, distant metastasis and associated morbidity and mortality), appears to be primarily a function of the age of the malignant neoplasm and therefore the more malignant ones are found most frequently in older persons. Young cancers, usually but not always found in youthful patients, are relatively benign but nevertheless are probably simply a benign phase of a malignant neoplasm - not benign neoplasms. In this phase they are probably capable of being eradicated. The very malignant Group III cancers are probably simply an expression of increasing malignancy from a less malignant histological cancer rather than a separate neoplasm arising de novo in a normal thyroid gland. These concepts contravene many of the current conventional concepts of thyroid malignancy. Nevertheless they seem valid and if so they resolve many of the contradictions and paradoxes which have existed as the result of a concept of the behavior of thyroid cancer based solely or preponderantly upon morphological characteristics.