- Part 1 Principles of international endocrine practice
- Part 2 Pituitary and hypothalamic diseases
- Part 3 The thyroid
- 3.1 Evaluation of the thyroid patient
- 3.2 Aetiology of thyroid disorders
- 3.3 Thyrotoxicosis and related disorders
- 3.3.1 Clinical assessment and systemic manifestations of thyrotoxicosis
- 3.3.2 Thyrotoxic periodic paralysis
- 3.3.3 Thyrotoxic storm
- 3.3.4 Subclinical hyperthyroidism
- 3.3.5 Causes and laboratory investigations of thyrotoxicosis
- 3.3.6 Antithyroid drug treatment for thyrotoxicosis
- 3.3.7 Radio-iodine treatment of hyperthyroidism
- 3.3.8 Surgery for thyrotoxicosis
- 3.3.9 Management of Graves’ hyperthyroidism
- 3.3.10 Graves’ ophthalmopathy and dermopathy
- 3.3.11 Management of toxic multinodular goitre and toxic adenoma
- 3.3.12 Management of thyrotoxicosis without hyperthyroidism
- 3.4 Hypothyroidism and pregnancy- and growth-related thyroid disorders
- 3.5 Thyroid lumps
- Part 4 Parathyroid, calcium, and bone metabolism
- Part 5 The adrenal gland and endocrine hypertension
- Part 6 Neuroendocrine tumours and genetic disorders
- Part 7 Growth and development during childhood
- Part 8 Female endocrinology and pregnancy
- Part 9 Male hypogonadism and infertility
- Part 10 Endocrinology of ageing and systemic disease
- Part 11 Endocrinology of cancer
- Part 12 Obesity, lipids, and metabolic disorders
- Part 13 Diabetes mellitus
Management of toxic multinodular goitre and toxic adenoma
- Chapter:
- Management of toxic multinodular goitre and toxic adenoma
- Author(s):
Dagmar Führer
and John H Lazarus
- DOI:
- 10.1093/med/9780199235292.003.3224
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. 3.3.11.1).
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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- Part 1 Principles of international endocrine practice
- Part 2 Pituitary and hypothalamic diseases
- Part 3 The thyroid
- 3.1 Evaluation of the thyroid patient
- 3.2 Aetiology of thyroid disorders
- 3.3 Thyrotoxicosis and related disorders
- 3.3.1 Clinical assessment and systemic manifestations of thyrotoxicosis
- 3.3.2 Thyrotoxic periodic paralysis
- 3.3.3 Thyrotoxic storm
- 3.3.4 Subclinical hyperthyroidism
- 3.3.5 Causes and laboratory investigations of thyrotoxicosis
- 3.3.6 Antithyroid drug treatment for thyrotoxicosis
- 3.3.7 Radio-iodine treatment of hyperthyroidism
- 3.3.8 Surgery for thyrotoxicosis
- 3.3.9 Management of Graves’ hyperthyroidism
- 3.3.10 Graves’ ophthalmopathy and dermopathy
- 3.3.11 Management of toxic multinodular goitre and toxic adenoma
- 3.3.12 Management of thyrotoxicosis without hyperthyroidism
- 3.4 Hypothyroidism and pregnancy- and growth-related thyroid disorders
- 3.5 Thyroid lumps
- Part 4 Parathyroid, calcium, and bone metabolism
- Part 5 The adrenal gland and endocrine hypertension
- Part 6 Neuroendocrine tumours and genetic disorders
- Part 7 Growth and development during childhood
- Part 8 Female endocrinology and pregnancy
- Part 9 Male hypogonadism and infertility
- Part 10 Endocrinology of ageing and systemic disease
- Part 11 Endocrinology of cancer
- Part 12 Obesity, lipids, and metabolic disorders
- Part 13 Diabetes mellitus