Thyroid adenoma

Adenoma is the most common thyroid tumor. It is a benign tumor. Follicular adenoma is formed by epithelial cells, is solitary, encapsulated and well differentiated. It can occur solitarily and multiple times. Multiple occurrence is typical of the so-called polynodose goiter , which is a multiple disease of the thyroid gland by adenomas and cysts.

Etiology and pathogenesis

The etiology of the disease is unknown. Affected are mostly women, especially those over the age of 50.

Clinical signs

There are a number of histological types, some of which retain the ability to produce thyroid hormones. Such adenomas can manifest themselves in thyrotoxicosis - we speak of the so-called toxic adenoma. Other clinical manifestations may include a locally visible or palpable node.

Differential diagnosis here requires a puncture biopsy .

Diagnostics

Ultrasound imaging of the thyroid gland (2, 4); A. carotis communis (1, 5), Trachea (3), and Vena jugularis (6)

Malignancies should always be ruled out for any palpable resistance in the thyroid gland. In the diagnosis of adenoma (and differentiation of malignant tumor) the following is used:

  • medical history;
  • physical examination (aspection, palpation);
  • USG;
  • USG + FNAB (fine needle aspiration biopsy) followed by cytopathological examination).

Therapy

Therapy can be divided into conservative and surgical, with surgery usually being approached after conservative treatment is ineffective.

  1. Conservative treatment: substitution-suppression therapy (thyrostatics, synthetic analogues of thyroid hormones - levothyroxine).
  2. Surgical: hemithyroidectomy, subtotal thyroidectomy, almost total thyroidectomy, total thyroidectomy.


CAVE!!!: During thyroid surgery, it is important not to damage the recurrent laryngeal nerve , superior laryngeal nerve and parathyroid glands . Another possible complication is perioperative bleeding.


Literature

  • KLENER, Pavel. Vnitřní lékařství. 3. edition. Praha : Galén, 2006. 1158 pp. ISBN 80-7262-430-X.
  • POVÝŠIL, Ctibor. Speciální patologie. 2. edition. Praha : Galén, 2007. 430 pp. ISBN 978-807262-494-2.
  • KLOZAR, Jan. Speciální otorinolaryngologie. 1. edition. Praha : Galén, 2005. 224 pp. ISBN 80-7262-346-X.


Kategorie:Vnitřní lékařství Kategorie:Endokrinologie Kategorie:Otorhinolaryngologie Kategorie:Chirurgie