To the Editor:— InThe Journal, Oct. 22, 1960, there was an editorial on carcinoma of the thyroid gland based on a review of a text written by Lindsay. The contention of Lindsay that most carcinomas of the thyroid do not originate in preexisting benign nodules, is of course not original with the author, this hypothesis having been advanced for many years. Nor is the conclusion that the prophylactic removal of benign nodules, etc., a new idea. How is one to know whether or not an apparently benign nodule of the thyroid is malignant or not until it has been subjected to a careful microscopic study by a pathologist? Merely to cause regression in the size of the goiter by thyroid therapy, I 131 , x-ray, etc., is, in my opinion, not sufficient. The tumor must be entirely eradicated by surgery to prevent the possibility of either hyperthyroidism, malignancy, or any