Thyroid nodules and cancer

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In the early 1900s surgeons boldly undertook the surgery of patients with endemic goiter and those who had Graves’ disease. Many patients were relieved by the operation. The introduction of iodine into our foodstuffs, the development of drugs for Graves’ disease, and the use of radioactive iodine have largely diminished the need for surgery in the treatment of these two entities. Nevertheless, the surgeon has a continuing role in the diagnosis and treatment of benign and malignant conditions of the thyroid.

Congenital lesion

Failure of closure of the lumen of the thyroglossal tract may result in the formation of a thyroglossal cyst which appears in the anterior portion of the neck above the thyroid gland. If the tract communicates with the pharynx, contains bacteria and is infected, an abscess forms and drains externally, forming a sinus tract in the anterior portion of the neck. Proper treatment consists of complete excision of the intact cyst, or if there is a communication with the pharynx, complete excision of the entire tract including the central portion of the hyoid bone up to the foramen cecum.

Thyroid cysts

Needle aspiration cures or controls approximately 90% of all thyroid cysts. If they recur and require a second aspiration, we have found that after aspiration the injection of the sclerosing solution, such as that used to obliterate varicose veins, is of value. If the cyst is persistent, and in younger patients, if it is of cosmetic significance, it may be removed surgically.

Nodular goiter

Most important. . .



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