Journal of Postgraduate Medicine
 Open access journal indexed with Index Medicus & ISI's SCI  
Users online: 8562  
Home | Subscribe | Feedback | Login 
About Latest Articles Back-Issues Articlesmenu-bullet Search Instructions Online Submission Subscribe Etcetera Contact
 ::   Next article
 ::   Previous article
 ::   Table of Contents

 ::   Similar in PUBMED
 ::  Search Pubmed for
 ::  Search in Google Scholar for
 ::Related articles
 ::   Citation Manager
 ::   Access Statistics
 ::   Reader Comments
 ::   Email Alert *
 ::   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded252    
    Comments [Add]    
    Cited by others 14    

Recommend this journal


Year : 2001  |  Volume : 47  |  Issue : 4  |  Page : 244-7

Thyroid nodules in Graves' disease: implications in an endemically iodine deficient area.

Department of Endocrine Surgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow - 226 014, India., India

Correspondence Address:
A Mishra
Department of Endocrine Surgery, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow - 226 014, India.
Login to access the Email id

Source of Support: None, Conflict of Interest: None

PMID: 11832639

Rights and PermissionsRights and Permissions

BACKGROUND AND AIM: The presence of thyroid nodules with Graves' disease raises concern about co-existent thyroid malignancy. The objective of this study is to evaluate the risk of thyroid carcinoma and the need for surgical intervention in, patients with Graves' disease with co-existent nodules in an endemically iodine deficient area (IDA). SUBJECTS AND METHODS: Retrospective study of 130 surgically managed patients of Graves' disease (1990-1999). Out of these 35 (26.9%) cases had palpable nodules. No patient had history of previous head and neck irradiation or radioiodine therapy. The clinico-pathological findings and follow-up of these cases were noted. RESULTS: Mean age of patients with nodules was 40.2 +/- 9.5 years and male to female ratio was 1:2.2. The overall incidence of thyroid carcinoma in Graves' disease was 6.2% (8/130 cases), while the incidence, in cases having nodule with Graves' disease was 17.1% (6/35 cases). The median age of patients with carcinoma was 45 years (5 women and 1 man). Besides laboratory investigations for hyperthyroidism, preoperative investigations included fine needle aspiration cytology (FNAC) and thyroid scintigraphy in 29 and 25 cases respectively. Incidence of malignancy in palpable cold nodules was 20%. FNAC could not predict malignancy with certainty in any of these cases. Five patients had papillary thyroid carcinoma while one had follicular carcinoma. Median tumour diameter was 10 mm. Tumour was multi-centric in two cases while one case had metastases to cervical lymph node. In follow-up (median =5.5 years) one patient died of unrelated cause, while rest are alive with no evidence of disease. CONCLUSIONS: Nodules are frequently associated with Graves' disease in IDA. Incidence of carcinoma is high in palpable cold nodule. We recommend early thyroidectomy in these cases.


Print this article     Email this article

Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow