The Effect of Total Thyroidectomy on the Function of Metastatic Thyroid Cancer*†

SEVERAL investigators have reported that treatment with radioactive iodine is not only an effective form of therapy in controlling the thyrotoxicosis of Graves' disease but that such treatment may cause the goiters of this malady to disappear. Chapman and Evans (1) have demonstrated that such treatment results in a destruction of thyroid tissue. Such effects of this form of irradiation on the thyroids of hyperfunctioning hyperplastic goiters have led many clinicians to ask if this form of treatment might be beneficial in cancer of the thyroid. Unfortunately most cancers of the thyroid have little or no function and are incapable of concentrating iodine. Seidlin, Marinelli and Oshry (2) have had the rare opportunity to study a patient having hyperthyroidism which arose from a widely metastasized hyperfunctioning cancer of the thyroid. Radioiodine administered to their patient was retained by all of the known metastases in concentrations great enough to warrant administering this isotope in therapeutic doses. However, as will be seen from several reported studies, this is an unusual situation.