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Continuing Occurrence of Thyroid Nodules After Head and Neck Irradiation: Relation to Plasma Thyroglobulin Concentration

ARTHUR B. SCHNEIDER, M.D., Ph.D.; CARLOS BEKERMAN, M.D.; MURRAY FAVUS, M.D.; LAWRENCE A. FROHMAN, M.D.; CLICERIO GONZALEZ, M.D.; U. YUN RYO, Ph.D.; GRANT SIEVERTSEN, M.D.; and STEVEN PINSKY, M.D.
[+] Article and Author Information

Grant support: in part by grant CA 21518 from the National Cancer Institute. Dr. Schneider is the recipient of Research Career Development Award AM 00103 from the National Institute of Arthritis, Metabolism and Digestive Diseases.

▸Requests for reprints should be addressed to Arthur B. Schneider, M.D.; Department of Medicine, Michael Reese Hospital and Medical Center, 2900 South Ellis Avenue; Chicago, IL 60616.


Chicago, Illinois


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(2):176-180. doi:10.7326/0003-4819-94-2-176
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We re-examined 158 subjects from a group of 226 previously normal persons who had received head and neck irradiation, 113 with elevated plasma thyroglobulin levels at their first visit and 113 with normal levels. Twenty-four subjects had thyroid scintigrams that had changed in the follow-up interval of 24 to 60 (mean = 45.3) months. Twelve subjects subsequently had thyroidectomy, and five malignancies were found. In the other 12 the changes tended to be more subtle, but in nine they very likely represented thyroid nodules. We conclude that the prevalence of radiation-induced nodules is not decreasing. More changes (17 of 24) occurred in subjects who initially had elevated plasma thyroglobulin levels (p < 0.05). However, the difference was not significant when the analysis was limited to the almost certain development of a nodule. Longer follow-up will be needed to ascertain whether a high thyroglobulin level predicts a greater risk of developing thyroid nodules.

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