PRONOUNCED EXOPHTHALMOS IN A CASE OF ADENOMATOUS GOITRE WITHOUT HYPERPLASIA

Abstract

Not all are agreed as to whether there is any vital difference between the thyrotoxicosis associated with an adenomatous goitre, and the hyperthyroidism of Graves' disease (exophthalmic goitre). But most authorities are willing to concede that there is a clear differentiation possible between the clinical features of these two types of goitre. It is beside the point, in this communication, to enter into any lengthy discussion of this controversy. Suffice it to state that “adenomatous goitre with hyperthyroidism” (Plummer's disease) is clinically characterized by an asymmetrical nodular enlargement of the thyroid gland in which a thrill is not palpable, and a bruit is not audible, and in which exophthalmos and the so-called thyroid eye signs (VonGraefe, Moebius, Dairymple, Joffroy, Stellwag) are absent. Graves' disease (exophthalmic goitre), on the other hand, is typified by a symmetrical smooth, highly vascular hyperplastic gland in which a thrill is palpable and bruit audible, and in which exophthalmos a...