[Malignant struma: changes in the clinical picture and treatment strategy]

In the Alpine countries of Switzerland and Austria iodized salt prophylaxis has greatly reduced the incidence of disease of the thyroid gland and substantially altered the pattern of malignant goitre: the previously dominant follicular carcinoma has diminished in number whereas there has been a corresponding increase in the papillary type. The number of highly malignant tumours has dwindled quite markedly within a few decades. Improved preoperative diagnosis and broader indications for surgery have been instrumental in causing most thyroid carcinomas to be treated today at an early stage. In papillary and follicular carcinomas cure rates are very gratifying if optimal advantage is taken of present strategies of treatment and aftercare. The otorhinolaryngologist should familiarize himself with modern thyroid medicine. He must realize first and foremost that thyroid malignancy today presents with much milder symptoms than the older medical literature led him to believe. Thyroid carcinoma is by no means rare in our outpatient departments.