Thyroid carcinoma—Biologic behavior and mortality:Postmortem findings in 42 cases, including 27 in which the disease was fatal

Thirty-three autopsy cases of clinical thyroid carcinoma were studied as to types, precursor changes and biologic behavior of the tumors. Eleven carcinomas were of the solid type; 13 were spindle and giant cell and the remainder were papillary, follicular or both. The findings indicate that spindle and giant cell carcinomas arise from the papillary and follicular type. No precursor changes were found in the other tumors or in 9 occult carcinomas found at autopsy. The biologic behavior of all types, other than the spindle and giant cell, is unpredictable; survivals vary from a few months to 20 years or longer. The mortality rate is much higher than commonly is believed: Among the 554 patients treated, it was 19%. The treatment for all thyroid carcinomas is total thyroidectomy.