Objective：To investigate the diagnosis and treatment of nodular goiter with thyroid carcinoma.
Methods：The clinical data of forty cases of nodular goiter with thyroid carcinoma admitted to our hospital from January 2005 to December 2007 were retrospectively analyzed.
Results：Among the 40 cases, only four cases were preoperatively diagnosed as nodular goiter with thyroid carcinoma. All cases received operation and the diagnosis were comfirmed by frozen section examination. Various modes of thyroidectomy were performed according to the pathological results, including four cases had unilateral total thyroidectomy, 27 had unilateral total thyroidectomy combined with opposite subtotal thyroidectomy, one case had bilateral subtotal thyroidectomy, and eight cases of bilateral total thyroidectomy. Of all 40 cases, 11 cases received unilateral cervical lymph node dissection. There were only three cases occurred convulsion or numbness, and no hoarseness occurred postoperatively. Compared to simple nodular goiter, the incidence of calcification in nodular goiter with thyroid carcinoma was significantly increased (P＜0.05). The incidence of carcinoma in single thyroid nodules was higher than that in unilateral multiple nodules(P＜0.01).
Conclusions：When an unilateral solitary nodule or a thyroid nodule with calcification is found, the possibility of malignancy should be highly considered and aggressive surgery is mandated. The patients with nodular goiter suspected of thyroid carcinoma should have intraoperative frozen section examination to confirm the diagnosis. Nodular goiter with thyroid carcinoma should be treated according to the  principles of thyroid carcinoma.