Struma maligna raises some questions concerning carcinogenesis, precancerosis, as well as diagnosis, therapy and prognosis. Only little information can be obtained by evaluating morphological criteria. Usually exhibiting modest malignancy papillary carcinoma as well as C-cell-carcinoma of the thyroid deserve particular interest. With regard to the velocity of growth (organoid arrangement of tumour tissue), also folliculoid carcinoma (i.e. Struma Langhans) will differ from so-called 'true' carcinomas characterized by a slower rate of growth. All other types of carcinoma, including sarcoma, represent tumours with rapid growth, accompanied by early formation of metastases.--In this connection all considerations concerning the usefulness of the so-called 'concept of pre-cancerosis' for the thyroid are thought to be very important. Realizing an atypical adenoma seems to be promising in evaluating this concept.

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