The thyroid nodule; a study of its significance as related to its size and known duration.

Is the routine removal of all thyroid nodules justified? Is the size of a thyroid nodule significant? Are multiple nodules unlikely to mean carcinoma? Is the duration of the nodule of importance? Should the fact that an unsuspected lesion is found on routine examination influence the advice to the patient? Answers to these questions have been looked for in 155 lesions operated upon by me and 220 removed by the other members of the Surgical Department of the Straub Clinic since 1947. Terminology In this report, the term adenoma is meant to signify epithelial neoplasm as distinguished from a non-neoplastic thyroid nodule. In some instances this distinction is difficult, but it has been based on both the gross appearance of the lesion and the usual microscopic features that distinguish a true adenoma (Shields Warren5). Table 1 classifies histologically these 375 nodular thyroids. One hundred six were characteristic of nontoxic