THYROID NODULAR DISEASE - IS IT TOXIC OR NONTOXIC, MALIGNANT OR BENIGN

The thyroid gland is known to become more nodular with age. The clinic al questions in a given patient are whether the nodule(s) is benign or malignant and euthyroid or toxic. Toxic multinodular goiter (MNG) is more common in the elderly than. Graves' disease but is not associated with the classic eye or skin findings. Drug therapy is usually effect ive, but total thyroidectomy may be preferred. Nontoxic MNG is common, among older women. Treatment remains controversial because of potenti al side effects of suppressive therapy. Although thyroid carcinoma is rare, most of the more aggressive tumors are seen after age 50. Fine-n eedle aspiration and cytologic examination are useful in separating be nign from malignant tumors.