Solitary toxic adenoma of the thyroid gland

Abstract

The incidence of solitary toxic adenoma of the thyroid in a general surgical unit with an interest in thyroid disease has been reviewed over a 15-year period. Six hundred and thirty thyrotoxic cases were treated surgically, 35 (5.6 per cent) having a solitary toxic adenoma. Thyroid enlargement or toxicity had been present for more than 5 years in 7 patients (20.0 per cent). Cardiovascular complications were present in 6 cases (17.1 per cent). Thyroid lobectomy resulted in 30 (85.7 per cent) euthyroid and 5 (143.3 per cent) hypothyroid patients. One toxic adenoma contained a focus of carcinoma. The clinical features, diagnosis and management of solitary toxic adenoma, and the management of symptomatic nodules which are 'hot' but not biochemically toxic, are discussed.

Percutaneous ethanol injection treatment of autonomous thyroid adenoma: hormonal and clinical evaluation

“…Treatment of toxic AFTA is usually accomplished by surgery or radioactive iodine (Thomas & Croom, 1987;McConahey, 1986). Surgery is safe and effective: complications such as hypoparathyroidism, vocal cord paralysis, and hypothyroidism are rare when surgery is performed by experienced teams (Thomas & Croom, 1987;Bransom et al, 1979;Gorman & Robertson, 1978;Eyre-Brook & Talbot, 1982;Falk, 1990). Its main drawback lies in its high cost; in addition, some patients are not acceptable surgical risks.…”

Relative Quantification of Indium-111 Pentetreotide and Gallium-68 DOTATOC Uptake in the Thyroid Gland and Association with Thyroid Pathologies

“…This finding clearly indicates that pentetreotide uptake was located in the hot thyroid nodule and was most likely the result of increased SSTR expression in this area und thus further characterizes and confirms the specificity of this finding for hot nodules. The histology of the one surgically removed hot nodule did not show lymphocytic infiltration and systematic histologic investigations of hot nodules did not describe lymphocytic infiltration in hot nodules (40)(41)(42). Therefore, lymphocytic infiltration is an unlikely explanation for the In-111 pentetreotide and Ga-68 DOTATOC uptake in single hot nodules and toxic multinodular goiters.…”

Iatrogenic Hypothyroidism and Its Sequelae

“…Patients who undergo lobectomy for an autonomously functioning nodule or a toxic solitary nodule may develop transient subclinical hypothyroidism postoperatively [7] but are usually euthyroid 10 years after thyroidectomy, with an incidence of hypothyroidism of 14-22% [8,9] .…”