Prevalence and Predictors of Incidental Thyroid Carcinoma in Patients With Graves' Disease Undergoing Thyroidectomy.

Who May Qualify: - Age 18 years or older. - Confirmed diagnosis of Graves' disease based on clinical features (e.g., diffuse goiter, ophthalmopathy if present) and biochemical evidence (suppressed TSH, elevated free T4 and/or T3) and/or positive TSH receptor antibody (TRAb) test. - Indication for total thyroidectomy for Graves' disease, based on established guidelines: Relapse or persistence of hyperthyroidism after a course of antithyroid drugs (ATDs). Intolerance or adverse reaction to ATDs. Patient preference for surgery over radioactive iodine (RAI) or long-term ATDs. Presence of a large goiter causing compressive symptoms. Coexisting suspicious thyroid nodule(s) on preoperative evaluation. Moderate to severe active Graves' ophthalmopathy where RAI is relatively contraindicated. - Patient is scheduled for total thyroidectomy (near-total or subtotal thyroidectomy patients will be excluded). - Ability and willingness to provide written willing to sign a consent form. - Ability to understand study procedures and requirements. Who Should NOT Join This Trial: - Age less than 18 years. - Previous thyroid surgery. - Previous neck irradiation. - Preoperative diagnosis of thyroid malignancy confirmed by fine-needle aspiration (FNA) cytology (Bethesda V or VI) , the focus is on incidental carcinoma. - Inability to provide willing to sign a consent form (e.g., due to cognitive impairment). - Patients undergoing thyroidectomy primarily for reasons other than Graves' disease (e.g., primary indication is large non-toxic MNG). - Patients undergoing less than total thyroidectomy (e.g., lobectomy, subtotal thyroidectomy). Always talk to your doctor about whether this trial is right for you.