Toxic adenoma is a benign tumor that grows in the thyroid gland and causes an overproduction of thyroid hormone (hyperthyroidism). This condition is the cause of about 3-5% of cases of hyperthyroidism.
Toxic adenoma is one of the causes of hyperthyroidism, in addition to Graves' disease and Plummer's disease. This condition is characterized by the presence of a single tumor (lump) measuring at least 2.5 cm in the thyroid gland.
This tumor will cause an increase in thyroid hormone production so that it is at risk of causing thyrotoxicosis. Tumors in toxic adenomas are generally benign and rarely become cancerous.
Symptoms of Toxic Adenomas
In general, a toxic adenoma will cause a lump in the neck and symptoms of hyperthyroidism. The following is a breakdown of the symptoms of a toxic adenoma:
- Single lump or nodule on the front of the neck
- Heart palpitations (palpitations)
- Excessive sweating
- Skin feels moisturised and warm
- Tremors (shaking), especially in the hands
- Irregular heartbeat (arrhythmia)
- Tired, weak, nervous, and restless
- Muscle cramps
- Drastic weight loss, no change in appetite
- Menstruation becomes irregular
- Diarrhea
When to go to the doctor
Check with your doctor if you have a lump in the front of your neck or experience any of the symptoms listed above. A doctor's examination needs to be done so that this condition can be treated immediately and complications can be prevented.
Immediately see a doctor if the lump gets bigger, especially if it causes difficulty swallowing or breathing.
If you have been diagnosed with a toxic adenoma, have regular check-ups with your doctor to monitor the progress of the condition.
Causes of Toxic Adenomas
Toxic adenoma is caused by the growth of a benign tumor (adenoma) in the thyroid gland. This tumor growth will make the thyroid nodule become overactive in producing thyroid hormone. As a result, thyroid hormone levels in the body will be high, which eventually causes complaints and symptoms of hyperthyroidism.
The exact cause of toxic adenoma is not known with certainty, but there are several factors that can increase the risk of this condition, namely:
- Female gender
- Over 40 years old
- Have a history of goiter in the family
- Have or are suffering from goiter
Toxic adenoma diagnosis
To diagnose a toxic adenoma, the doctor will ask the patient's complaints and symptoms, as well as the patient's and family's medical history. Next, the doctor performs a thorough physical examination, including an examination of the head and neck area to assess for lumps.
The doctor will also perform the following investigations to confirm the diagnosis:
- Thyroid function test, to determine the amount of thyroid hormone, namely: triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH)
- Thyroid antibody test, to determine levels of antibodies produced by the thyroid gland, namely TPO (TPO)thyroid peroxidase antibodies), Tg (thyroglobulin antibodies), and the TSH receptor (thyroid-stimulating hormone)
- Thyroid ultrasound, to detect lumps in the thyroid gland
- Radioactive iodine level test, to assess the level of radioactive iodine absorbed by the thyroid gland over a certain period of time
Toxic adenoma can be characterized by low levels of TSH and TPO, as well as elevated levels of T3 and T4.
Toxic Adenomas Treatment
Treatment of toxic adenomas aims to relieve symptoms and prevent complications. Treatment can be done in several ways, namely:
Beta blockers (beta-blockers)
Beta-blockers are given to help relieve symptoms of hyperthyroidism, especially those related to the heart, blood vessels, and nerves, such as palpitations, tremors, and increased sensitivity to heat.
Antithyroid drugs
Antithyroid drugs work to suppress excessive thyroid hormone production. This drug can be used to control hyperthyroidism long-term in children, adolescents, and pregnant women.
In adult men and women who are not pregnant, this drug is usually used as an initial treatment before undergoing radioactive iodine therapy.
Radioactive iodine therapy
Radioactive iodine therapy serves to restore thyroid function by reducing tumor size. In this therapy, the patient will be asked to drink radioactive iodine. This iodine will then be absorbed into the thyroid gland and work by destroying the overactive tissue.
This method is considered effective because the results are better than the administration of antithyroid drugs and do not require hospitalization. However, this therapy should not be used in pregnant women, lactating women, and children under 5 years of age.
Thyroidectomy
Thyrodectomy is the surgical removal of part or all of the thyroid gland. This treatment is usually performed on children with severe hyperthyroidism, pregnant women, patients who cannot undergo radioactive iodine therapy, and people with heart problems.
Although it can be controlled with a number of treatment steps above, toxic adenomas are permanent. Therefore, keep doing regular check-ups to the doctor to monitor your condition even though you have been undergoing treatment.
Complications of Toxic Adenomas
There are several complications that can occur due to increased thyroid hormone levels in toxic adenomas, namely:
- Heart failure
- Atrial fibrillation
- Tachycardia
- Osteoporosis
- Thyroid crisis
In addition to the above conditions, complications can also occur in the form of difficulty breathing and swallowing due to an enlarged thyroid gland.
Prevention of Toxic Adenomas
The exact cause of toxic adenoma is unknown, so the best way to prevent this condition is to avoid the risk factors.
This can be done by conducting regular health checks, especially if you have had a goiter or have a family history of goiter. In addition, you are also advised to meet the intake of iodine.
