[The problem of malignant recurring goiter]

In a total of 29,060 autopsies at the Institute of Pathology, University of Zürich, between 1961 and 1973, 164 (0.56%) primary thyroid malignomas were diagnosed. 13 of these 164 patients with thyroid carcinoma showed a status post earlier strumectomy, representing 0.45% of the autopsies. On average 4.5% of the patients in our autopsy material had been previously thyroidectomized. The calculated chance combination of malignant thyroid tumor with status post earlier partial thyroidectomy is consequently 0.25%. This seems to suggest that malignomas develop nearly twice as often in previously operated thyroids, but histological review of these cases revealed that in 5 cases the primarily resected tumor had in fact to be reclassified as carcinoma. A further case probably belongs to the same group. Only in 7 cases (0.24%) did the carcinoma develop after partial strumectomy for a benign lesion. These percentage figures agree with the calculated probability of thyroid malignoma coinciding with previous strumectomy. Accordingly, these statistics lend no support to the contention that strumectomy predisposes the patient to thyroid malignoma.