[Nodular hyperthyroidism: surgical experience and hypothesis of carcinogenic correlations]

In a retrospective study 109 patients operated for nodular toxic goiter from 1984 to may 1988 are examined. Clinical feature, diagnosis and surgical approach are analyzed; the follow-up of the patients is reported as well. Some results are really interesting: 1) the incidence of hyperthyroidism in a nodular goiter (toxic multinodular goiter, solitary or multiple Plummer's nodes) is higher in the females; 2) most of the patients with solitary or multiple nodes are middle-young-aged; 3) prevalence of autonomous toxic adenomas; 4) relapses are higher (76%) in young patients with thyroid nodes operated with lobectomy and isthmectomy in pre-toxic stage (multifocality of the disease). Basedowified goiter, on the contrary, is present in old females with a long history of goiter. In these cases, subtotal thyroidectomy is often curative. The association with cancer is a fearful event to remember.