Incidence of Goiter with Benign and Malignat Thyroid Nodules Following Radiotherapy of Scalp in Childhood

We examined 812 subjects with a history of radiation to the head for the treatment of scalp worm infestation in during childhood. 36% of the subjects had goiters grades IA and II3. Another 134 subjects ( 17%) were found to have thyroid nodularity, 85 of whom bad solitary cold nodules. 43 patients whith either a solitary cold nodule or a multinodular goiter with a priominent cold nodule were operated on. All the lesions were benign (35 colloid goiter and 8 adenoma). A focus of papillary carcinoma ( < 1cm was accidentally found in the vicinity of a colloid goiter). Thyroid function tests were normal in all except one who was hypothyroid. In those who were operated, serum  T4 was decreased and serum T 3 and thyroglobuline levels were significantly higher, as compared to those with and without goiter. This study suggests that radiation to the head in childhood may not be an etiologic factor in the development of thyroid cancer. Thyroid nodularity in this group should be managed in the same way as those who do not have history of radiation.