Adenoma of the thyroid

Thyroid adenoma is the benign overgrowth of the thyroid gland, resulting in a small lump in the thyroid gland.

Prof. Avi Hefets – Head of the Head and Neck Surgery Department, Assuta Hospital. Leading Israeli expert in the treatment of disorders of the thyroid gland.

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Symptoms
The vast majority of thyroid nodules are not serious and do not cause symptoms. Most people do not know that they have a thyroid adenoma, until the doctor finds it by chance during a routine medical examination. But some thyroid nodules may be large enough that they can be seen, they cause difficulties in swallowing and breathing.

In some cases, thyroid nodules produce an extra thyroxine, a hormone produced by the thyroid gland. Additional thyroxine can cause symptoms of hyperthyroidism, such as unexplained weight loss, heat intolerance, tremor, nervousness, rapid or irregular heartbeat.

Some thyroid nodules may be malignant, but symptoms are difficult to determine. Although the size is not an indicator of malignancy of thyroid cancers longer look like the fast-growing fixed cones.

Despite the fact that thyroid adenoma is a benign form, it is necessary to consult a doctor to make a correct diagnosis of unusual swelling in the neck, especially if you have trouble breathing or swallowing. It is important to exclude the cancer.

Development of thyroid nodules can be sometimes caused by a lack of iodine in the body.

In many cases, as a result of degeneration of an adenoma of the thyroid gland are formed fluid-filled cavities (cysts). Often also solid components are mixed with the liquid cysts thyroid. The cysts are usually benign, but sometimes they may contain malignant solid components.

Chronic inflammation of the thyroid gland (thyroiditis), Hashimoto’s disease, thyroid disease may cause inflammation of the thyroid gland, which leads to the hub extension. It is often accompanied by a decrease in activity of the thyroid gland (hypothyroidism).

Multinodular goiter. “Goiter” is a term used to describe any increase in the thyroid gland, which can be caused by iodine deficiency or thyroid disease. Multinodular goiter contains several different nodules goiter, but the cause is less clear.

Complications
Complications associated with thyroid adenoma include as rule trouble swallowing or breathing. Large nodules or multinodular goiter – an enlarged thyroid gland that contains several different nodules – can interfere with swallowing or breathing.

Hyperthyroidism. Problems can arise when a node or goiter produces a thyroid hormone, which leads to hyperthyroidism. Hyperthyroidism can cause weight loss, muscle weakness, intolerance to heat, emotion, or irritability. Possible complications of hyperthyroidism include irregular heartbeat (atrial fibrillation), osteoporosis, thyrotoxic crisis, the sudden and potentially life-threatening and requires immediate medical involvement.

Once a thyroid nodule was discovered, it is imperative to visit an endocrinologist – a doctor who specializes in endocrine disorders.

Diagnostics
1. Physical examination: palpation of the thyroid. This test can evaluate the state of the thyroid and lymph nodes on the sides of the neck.
2. To date, most of the diagnostic methods include neck ultrasound, computed tomography (CT) of the chest and neck magnetic resonance imaging (MRI) or positron emission tomography (PET-CT).
3. The blood test includes a test of thyroid stimulating hormone (TSH), which determines the function of the thyroid gland, as well as T3 and T4. According to these tests, it is possible to assess whether there is an excess or deficiency of thyroid hormones. If there is an excess of thyroid hormones (lowest TSH, T4 and normal or high) should be clearly defined on the basis of whether an excessive secretion of one node (toxic adenoma) or multiple compounds (toxic goiter).
4. Taking a fine needle biopsy (FNA) to determine the type of fabric with suspicious characteristics in cases of patients with the risk of malignant disease. It is generally recommended to perform a biopsy only in the case, if the size of the nodule is more than 1 cm, except in special cases (for example, after exposure to external radiation). This procedure is safe and is used for many years by our experts. When the certificate examination in favor of benign node, it is still necessary to consult an experienced endocrinologist with further recommendations for treatment.
5. Other tests: If necessary, use other means to assess the status of the lymph nodes, such as checking calcitonin (for suspected medullary thyroid cancer), genetic tests for mutations.

Treatment
Most thyroid nodules do not cause any health problems, not painful, do not cause problems in appearance, and often diagnosed by chance during imaging or ultrasound. Nevertheless, some small thyroid nodules may cause problems.

If a nodule size no larger than 1 cm, it is recommended to repeat the test ultrasound 6-12 months, and then with a longer interval.

If a large adenoma, and puts pressure on nearby organs, or change a person’s appearance, surgery may be recommended partial or complete resection of the thyroid gland (thyroidectomy).

If a toxic adenoma, treatment may include: drugs, radioactive iodine or a surgical operation. As a rule, used drugs such as Methimazole, Propylthiouracil or that reduce the excess production of hormones. But this management is temporary.

Radioactive iodine is the most common treatment of toxic adenoma, and usually does not result in damage to cancer in other places it inactive.

The surgical option is also effective in the treatment of adenoma, since the implementation of its experienced surgeon, the risk of complications is very low. Selection between treatment with radioactive iodine and surgical method is determined for each patient individually, based on the diagnosis and depending on his medical history.