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The Natural History of the Autonomous Hyperfunctioning Thyroid Nodule

Ann Intern Med. 1967;67(3_Part_1):539-548. doi:10.7326/0003-4819-67-3-539
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The autonomous hyperfunctioning thyroid nodule is a well-established clinical entity (1, 2). Although the presence of such nodules has been associated in some instances with thyrotoxicosis, many patients with nodules sufficiently hyperactive to cause complete suppression of pituitary thyroid-stimulating hormone (TSH) production—and, in consequence, suppression of function within extranodular thyroid tissue—have been found to be clinically euthyroid (2-6). Whether any or all of these patients might ultimately become hyperthyroid has been the subject of considerable speculation (2, 7). A number of investigators (2, 5-10) have reported their cumulative experience with solitary hyperfunctioning thyroid nodules; however, since the vast majority of


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