Typically a single large thyroid nodule accompanied by clinical and biochemical hyperthyroidism.
Diagnosis confirmed by thyroid scan demonstrating a hot area and suppression of extranodular thyroid tissue.
Hyperthyroidism caused by toxic adenomas generally does not remit.
Definitive treatment, such as radioactive iodine therapy, is usually required.
Complications of untreated toxic adenomas may include sequelae of hyperthyroidism such as cardiac dysfunction or bone loss, or tracheal compression by large nodules.
A toxic adenoma is an autonomously functioning thyroid nodule which causes hyperthyroidism. These nodules are almost always benign. Some autonomous nodules cause only subclinical hyperthyroidism, with suppressed thyroid-stimulating hormone (TSH) level and normal concentrations of free thyroid hormones.
History and exam
Elizabeth N. Pearce, MD
Associate Professor of Medicine
Boston University Medical Center
ENP has received honoraria and travel funding for speaking at two international conferences for Merck Serono and at one for IBSA. She is a member of the Management Council of the Iodine Global Network. She is an author of a number of references cited in this topic.
Dr Elizabeth N. Pearce would like to gratefully acknowledge Dr Sheila Feit, the previous contributor to this topic.
John C. Morris, MD
Professor of Medicine
JCM declares that he has no competing interests.
Petros Perros, BSc, MBBS, MD, FRCP
PP declares that he has no competing interests.
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