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Thursday, 28 November 2013

Thyroid disease: Thyroid adenoma – The Complications and Disease associated to Thyroid adenoma

Thyroid is one of the largest endocrine glands found in the neck, below the Adam’s Apple with the function of regulating the body use of energy, make of proteins by producing its hormones as a result of the stimulation of thyroid-stimulating hormone (TSH) produced by the anterior pituitary.
Thyroid disease is defined as a condition of malfunction of thyroid.
Thyroid adenoma is a benign tumor started in the layer of cell lined the inner surface of the thyroid gland. The disease are relatively common among adults living in the United States. According to the study by the Mayo Clinic and Mayo Foundation, there is a report of 4 patients described in whom a follicular carcinoma developed following thyroidectomy for a benign follicular neoplasm. Most thyroid nodules are Thyroid adenoma.
C. Complications and Disease associated to Thyroid adenoma
C.1. Complications
1. Problems swallowing or breathing
If the tumor is growth large enough, it may be interfere with swallowing or breathing of the patient
2. Hyperfunctioning nodules and problems associated with thyroid cancer
Hyperfunctioning nodules of the thyroid are thought to only rarely harbor thyroid cancer, and thus are infrequently biopsied. According to the study by the The University of Texas Southwestern Medical Center, literature review of surgical patients with solitary hyperfunctioning thyroid nodules managed by thyroid resection revealed an estimated 3.1% prevalence of malignancy. A separate literature search uncovered 76 cases of reported malignant hot thyroid nodules, besides the present case. Of these, 78% were female and mean age at time of diagnosis was 47 years. Mean nodule size was 4.13 ± 1.68 cm. Laboratory assessment revealed T3 elevation in 76.5%, T4 elevation in 51.9%, and subclinical hyperthyroidism in 13% of patients(14).
C.2. Disease associated to Thyroid adenoma
1. Laryngopharyngeal primary squamous cell carcinoma
There is a report of three cases of laryngopharyngeal primary squamous cell carcinoma presenting with thyroid nodules. The key message to take away from these cases is that patients with advanced malignancy of the upper aerodigestive tract can present with a thyroid nodule(15).
2. Gastric adenocarcinoma than urine iodine level
The higher prevalence of goiter rather than low levels of urinary iodine in gastric adenocarcinoma cases suggests that goiter, perhaps due to protracted but currently adjusted iodine deficiency, is more likely to be associated with gastric adenocarcinoma compared to the existing iodine deficiency itself(16).
3. Papillary thyroid carcinoma
Whereas thyroid nodules are less common among children than among adults, the anxiety generated by the finding of a thyroid nodule is high because 20% of nodules found in children contain thyroid cancer. There is a report of a case of 11-year-old girl presented with heavy menses, fatigue, and a right thyroid mass. Laboratory evaluation revealed elevated triiodothyronine and undetectable thyroid-stimulating hormone. Thyroid ultrasonography revealed a 3.5 cm nonhomogenous nodule, and scintigraphy was consistent with an autonomous hyper-functioning nodule, according to the study by the University of Pittsburgh Medical Center(17).
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Sources
(14) http://www.ncbi.nlm.nih.gov/pubmed/23641736
(15) http://www.ncbi.nlm.nih.gov/pubmed/18344472
(16) http://www.ncbi.nlm.nih.gov/pubmed/23844325
(17) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933378/