Total thyroidectomy has been considered in the treatment of thyroid carcinoma for three major reasons: to ensure complete removal of the primary lesion or lesions, since a significant number of patients have multiple foci of cancer in the gland; to increase the uptake of radioactive iodine in metastatic lesions; and to prevent the possible development of another primary thyroid tumor. Current experience leads us to believe that the first reason is probably the most important one as an indication for total thyroidectomy. It has led us to perform this procedure with greater frequency in recent years.
I. Multicentricity of Thyroid Carcinoma.
In a review of 134 patients who underwent surgery for cure of thyroid carcinoma from 1943 through 1959 at the Henry Ford Hospital, 17, or 13%, were considered to have multiple foci of carcinoma in the thyroid tissue removed. Fifty-six patients in the group had a total or