[Presence of ophthalmopathy in all cases of Basedow disease?]. / Présence d'une ophtalmopathie dans tous les cas de maladie de Basedow?

In order to evaluate the frequency of ophthalmopathy in Graves' disease, we used a progression criterion, the variation of the eyeball protrusion, in a group of 145 patients initially examined at the time when thyrotoxicosis was diagnosed, before any treatment. By the means of a systematic measure of the protrusion with the Hertel's exophthalmometer at every consultation, we calculated for each patient the variation of protrusion (delta PO) between each annual mean value and the initial value. The mean survey was 6.4 years (range 1-18 years). For the whole group, we observed, after a slight increase (0.3 mm) during the first year, a progressive decrease, which reached about 4 mm at the 12th year and kept an afterwards (p < 0.01 at 3 years; p < 0.001 afterwards). The percentage of cases in which the decrease was significant related to the initial value (> or = 2 mm) rose regularly to reach 100% at the 16th year. These results seem to give evidence of the constant nature of ophthalmopathy at the initial stage of Graves' hyperthyroidism.

[Reliability of needle biopsy of solitary thyroid nodules in view of surgical indications]. / Fiabilité de la cytoponction des nodules thyroïdiens solitaires en vue des indications opératoires.

To evaluate the accuracy of fine-needle biopsy in the management of the solitary thyroid nodules, 320 biopsies without aspiration were performed in 212 patients, iteratively in 91 cases. Among the 212 initial biopsies, 93 smears were found presumably benign (43.9%), 6 malignant (2.8%), 49 benign implying cytologic control (23.1%), 24 suspicious with decision to operate (11.3%), 40 inadequate (18.9%). On 67 surgical indications (malignant or suspicious cytology, or clinical data), 59 operations were performed. The 11 diagnosed cancers (5.2% of the patients; 18.6% of the operations) correspond to six malignant and five suspicious cytologies at the first or second biopsy. On 145 cases without decision to operate, 125 were clinically surveyed, with sometimes another biopsy (mean survey: 27.6 months; range: 6-80 months), and it was never necessary to modify the initial expectancy attitude. Our results, rather similar to those related by most of the previous publications, confirm that the fine-needle biopsy is a reliable and effective means for the etiologic diagnosis of thyroid nodules and the indications for operative intervention. It spares many patients from a useless operation and is worthy to take a leading place in exploring these nodules.