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Management of toxic multinodular goitre and toxic adenoma 

Management of toxic multinodular goitre and toxic adenoma
Management of toxic multinodular goitre and toxic adenoma

Dagmar Führer

and John H Lazarus

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date: 17 May 2022

Toxic adenoma and toxic multinodular goitre represent the clinically important presentations of thyroid autonomy. Thyroid autonomy is a condition where thyrocytes produce thyroid hormones independently of thyrotropin (TSH) and in the absence of TSH-receptor stimulating antibodies (TSAB).

Toxic adenoma (TA) is a clinical term referring to a solitary autonomously functioning thyroid nodule. The autonomous properties of TA are best shown by radio-iodine or 99mTc imaging. The classic appearance of TA is that of circumscribed increased uptake with suppression of uptake in the surrounding extranodular thyroid tissue (‘hot’ nodule, Fig.

Toxic multinodular goitre (TMNG) is a heterogeneous disorder characterized by the presence of autonomously functioning thyroid nodules in a goitre with or without additional nodules. These additional nodules can show normal or decreased uptake (cold nodules) on scintiscan. TMNG constitutes the most frequent form of thyroid autonomy.

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