In recent years, several reports have suggested that the incidence of Hashimoto thyroiditis is on the rise1 and that there is an added risk of thyroid cancer in the presence of this disease.2
Surgical opinion is virtually unanimous that many symptomatic cases of chronic thyroiditis will inevitably progress to a state of permanent and frequently refractory myxedema.3 Consequently, the role of surgery is a secondary one. It serves as an instrument for diagnosis in the presence of solitary nodules and as a method of decompression for enlarging glands.
The surgeon ordinarily must deal with this disease under circumstances which predispose to errors in preoperative diagnosis. Frequently his patient either has recently developed an asymptomatic thyroid nodule or is experiencing pressure symptoms from an enlarging goiter, without physical or laboratory evidence to indicate an inflammatory process in the gland.
One feature of Hashimoto thyroiditis which has not received