Reply

Excerpt

The patient with a thyroid scan showing toxic diffuse goiter is the patient who had undergone radioiodine treatment for Graves’ disease 2 years before the diagnosis of malignancy. We are not certain whether the malignancy is associated with radioiodine treatment or whether it had been in the thyroid since the diagnosis of Graves’ disease. In another study [1], we found that most thyroid cancers with concurrent Graves’ disease were 10 mm or smaller. Thyroid scintigraphy revealed cold nodules in only 23.8% of the Graves’ patients with concurrent carcinoma. In addition, only 30.3% of the patients had fine-needle aspiration cytology findings indicating a need for surgical treatment. …