JAMA. 1962;181(3):251-252. doi:10.1001/jama.1962.03050290073014.
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The management of nontoxic nodular goiter has been and continues to be a controversial subject. The usually accepted surgical viewpoint was summarized in 1945 by Cole and his associates,1 who called attention to the hazards of malignancy in this condition. As a result of the statistics presented by Cole and subsequently supported by other surgical reports, a number of surgeons and physicians recommend thyroidectomy without delay whenever nodularity is detected in a thyroid gland. This recommendation is based on the premise that many apparently benign thyroid nodules are in fact malignant, and that it is impossible to distinguish between benign nodular goiter and thyroid cancer at a time when the latter is still amenable to complete surgical extirpation. Strong opposition to this policy of procedure has been voiced. Members of the opposition have insisted that only a small fraction of nodular goiters are malignant, that these may be differentiated


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