A 52 years old male with toxic adenoma, treatment of choice is -
Toxic adenoma A solitary toxic nodule is the cause of less than 5% of all cases of thyrotoxicosis. The nodule is a follicular adenoma, which autonomously secretes excess thyroid hormones and inhibits endogenous TSH secretion, with subsequent atrophy of the rest of the thyroid gland. The adenoma is usually greater than 3 cm in diameter. Most patients are female and over 40 years of age. Although many nodules are palpable, the diagnosis can be made with ceainty only by thyroid scintigraphy (see Fig. 20.4, p. 742). The thyrotoxicosis is usually mild and in almost 50% of patients the plasma T3 alone is elevated T3 thyrotoxicosis). 131I (400-800 MBq (10-20 mCi)) is highly effective and is an ideal treatment since the atrophic cells surrounding the nodule do not take up iodine and so receive little or no radiation. For this reason, permanent hypothyroidism is unusual. A surgical hemithyroidectomy is an alternative. DAVIDSONS PRINCIPLES AND PRACTICE OF MEDICINE 22ND EDITION PAGE NO-754
Surgical-removal of adenoma
Radiotherapy
Radioactive Ij
Medical treatment
Endocrinology