In a consecutive series of 172 patients with Graves' disease treated by total thyroidectomy, 15 patients (9%) had an associated unsuspected carcinoma. There were 20 patients who had received prior treatment with radioactive iodine; 3 (15%) had carcinoma. The high incidence of thyroid carcinoma found in this series suggests that when surgery is elected as the treatment of choice in any given case of Graves' disease, nothing less than a total thyroidectomy should be performed. This high incidence would further indicate that surgery should be given even greater consideration in the selection of a modality for the management of any specific case of Graves' disease.
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