The concept of an adenoma of the thyroid gland
Tiroksicheskaya adenoma - a diseaseaccompanied by increased function of the thyroid gland with high amounts of thyroid hormones in the blood. At the same time production of thyroid hormones is due to their increased production adenoma (benign tumor formation of glandular tissue) of the thyroid gland.
Thyroid adenoma may be singleor less, there are several adenomas. Most often the disease occurs in women (3-4 times more often than men). Very often in women between 40 and 60 years. The frequency of toxic adenoma of the thyroid gland increases in regions of endemic goiter.
Dimensions thyrotoxic adenoma usually small- Up to three centimeters in diameter. Its feature is that it strongly produces thyroid hormones (mainly triiodothyronine), regardless of the regulatory action of the pituitary. A large number of hormones suppress pituitary function, thyrotropin reduced products, and the remaining thyroid tissue reduces its function.
Sometimes thyrotoxic adenoma occurs earlierexisted nontoxic site. Therefore, the presence of nodules in the thyroid gland increases the risk of toxic adenoma. Proyaleniya toxic adenoma of the thyroid gland are similar to clinical manifestations of diffuse toxic goiter.
At current there are two forms of toxic adenoma:
When compensated toxic adenoma tissuethyroid continues to function normally, the pituitary hormone production and signs of relative preservation gipertiroza appear insignificant.
Decompensated form toxic adenomathyroid characterized by severe manifestations tirotoksikoza and a significant reduction in the production of thyrotropin hypothalamus. Unlike diffuse toxic goiter average age of patients with adenoma tirotoksicheskoy much older and develop the disease more slowly.
The initial manifestations of toxic adenoma of the thyroid gland:
- weight loss in the absence of changes in diet and lifestyle
- poor tolerance of heat and heat
- palpitations, continued alone, and even in a dream
- fatigue during exercise
In elderly patients, the only complaints arebe heart palpitations and shortness of breath on exertion, fatigue, drowsiness or insomnia. In the further course of the disease there are violations on the part of the gastrointestinal tract, increased blood pressure, sometimes there is a constant slight increase in body temperature. The skin of the patient is moist, warm limbs. However, changes in skin color and symptoms of the eyes in this disease are usually absent. Changes in the cardiovascular system is gradually progressing, there is atrial fibrillation, myocardial thyrotoxic, which eventually lead to the development of heart failure.
Diagnosis of the disease
The diagnosis of adenoma is set tirotoksicheskoybased on a survey and examination of the patient. When palpation of the thyroid gland revealed an increase in one of the thyroid lobes, it is possible to test the unit. We study the blood levels of thyroid hormones. Moreover, the amount of triiodothyronine (T3) is greatly improved, and the level of thyroxine may be almost normal. Number of blood TSH (pituitary hormone) may be normal or reduced. Radioisotope thyroid scan can detect "hot" node actively accumulating radioactive iodine. In the biochemical analysis of blood show signs of protein, fat and carbohydrate metabolism.
Tirotoksicheskaya adenoma is a benign tumor formation and its transition into a malignant form is very rare.
Methods of treatment of toxic adenoma of the thyroid gland
Treatment tirotoksicheskoy adenoma surgery. In the preoperative period, applies tirostaticheskaya therapy in the presence of severe toxicity. Prescribe drugs that suppress thyroid function (tiamazol, carbimazole, propitsil). The patient will need to provide mental calm, restful sleep. You can not be in the sun. Assigned a diet with more protein in the diet, vitamins. Sometimes prescribed beta-blockers.
Further surgery is performed: adenoma of the thyroid gland is removed surgically. Sometimes elderly patients being treated with radioactive iodine. Tirotoksicheskaya adenoma actively collects such iodine and radioactive iodine under the influence adenoma cells are destroyed, and it ceases to function.
There is also a method of treatment, when administered directly to the hostethyl alcohol from 1 to 8 ml. Such injections are repeated several times. It is believed that this is accompanied by destruction of the unit and toxic adenoma hormone production stops.
The prognosis of thyrotoxic adenoma satisfactory. Malignant transformation occurs very rarely, including the after treatment of radioactive iodine therapy.