Toxic adenoma

Toxic adenoma is a thyroid adenoma that increasingly produces thyroid hormones. Hyperthyroidism is present, which is not affected by pituitary feedback. Symptomatic adenomas are more common in the elderly.

Clinical manifestations
Hypercirculatory symptoms predominate, cardiac symptoms may occur but endocrine orbitopathy usually isn't present. The symptoms are typical of Graves' disease. Adenomas with dimensions over 3 cm are clinically evident.

Diagnosis
Elevated levels of thyroid hormones (TSH, fT4, fT3), scintigraphy (↑ accumulation of radioisotope in the node) supplemented by biopsy to rule out malignancy is important for diagnosis.

Treatment
Strumectomy provides a definitive solution. Preoperative remission of thyrostatics is necessary before the operation, usually the toxic adenoma does not calm down and therefore the operation is started. When thyroidectomy is contraindicated ,radioiodine is administered. Thyroid adenomas are necrotized less frequently by targeted ethanol injection.

Related Articles

 * thyroid hormones
 * thyroid adenoma
 * Graves disease
 * Thyrotoxic crisis