What Is Thyroid Adenoma?
Thyroid adenoma is a benign tumor originating from thyroid follicular cells and is the most common benign tumor of the thyroid gland. Occurs during the active phase of thyroid function. Follicular and papillary solid adenomas are classified clinically, the former is more common. It is usually a single well-defined nodule in the thyroid sac, with a complete envelope, 1-10 cm in size. The disease is sporadic throughout the country and is more common in endemic goiter areas.
Basic Information
- English name
- thyroidadenoma
- Visiting department
- Endocrinology
- Multiple groups
- Women under 40
- Common causes
- Gender, oncogene, familial tumor syndrome, external radiation exposure, TSH overstimulation
- Common symptoms
- Neck mass
Causes of thyroid adenoma
- The etiology of thyroid adenoma is unknown, and may be related to gender, genetic factors, radiation exposure, TSH overstimulation, and endemic goiter disease.
- Gender
- The incidence of thyroid adenoma in women is 5-6 times that of men, suggesting that gender factors may be related to the incidence.
- 2.Oncogene
- The expression of oncogene c-myc can be found in thyroid adenoma. Adenomas can also be found in activating mutations and overexpression of the oncogene H-ras. Mutations in proteins involved in the TSH-G protein adenine cyclase signaling pathway can also be found in high-function adenomas, including mutations in the extracellular and transmembrane segments of the TSH receptor transmembrane domain and the stimulation of GTP-binding proteins. mutation.
- 3. Familial tumor syndrome
- Thyroid adenomas can be seen in some familial tumor syndromes, including Cowden's disease and Catney's syndrome.
- 4.External radiation
- In childhood, the incidence of thyroid tumors also increased in people who had been treated with X-rays on the head, neck, and chest.
- 5.TSH overstimulation
- Some patients with thyroid adenoma may find that their blood TSH levels are increased, which may be related to their pathogenesis. It was found that TSH can stimulate the expression of pro-oncogene c-myc in normal thyroid cells, thereby promoting cell proliferation.
Clinical manifestations of thyroid adenoma
- Patients are mostly women, often under 40 years of age, and are usually single nodules in the thyroid. The course of the disease is slow, most of which are months to years or even longer, and the patient is found to have a neck mass due to slight discomfort or no symptoms. Most of them are single, round or oval, with smooth surface, clear borders, firm texture, no adhesion to surrounding tissues, no tenderness, and can move up and down with swallowing. Tumors are usually a few centimeters in diameter, and large ones are rare. Giant tumors can produce signs of compression in adjacent organs, but do not invade these organs. A small number of patients due to intratumoral hemorrhages may suddenly increase in size, accompanied by swelling and pain, such as papillary cystic adenomas; some lumps will gradually absorb and shrink; some may occur cystic changes. Those with a longer history often have tumours that are hardened by calcification; some can develop into functional autonomic adenomas that cause hyperthyroidism. Some thyroid adenomas can become cancerous. In the following cases, the possibility of malignant changes should be considered:
- 1. The tumor has rapidly increased recently.
- 2. Restricted or fixed tumor activity.
- 3. Compression symptoms such as hoarseness and difficulty breathing.
- 4. The tumor is firm, and the surface is rough.
- 5. cervical lymphadenopathy.
Thyroid adenoma examination
- 1. blood T 3 , T 4
- In the normal range. The function check is normal.
- 2.B-ultrasound
- It can be further clear whether the mass is solid or cystic, whether the edges are clear, the mass is mostly single or multiple, and it is 2 to 3 small masses, and the ipsilateral glandular lobe is correspondingly enlarged, and the solid is adenoma , Cystic is a thyroid cyst.
- 3. Isotope scan
- A 131 I scan showed a warm thyroid nodule and a cystic adenoma could be a cold nodule. Most thyroid nuclide scans are warm nodules, but they can also be hot or cold.
- 4. X-ray of neck
- If the tumor is large, the trachea may be compressed or displaced in the lateral view, and calcification may be seen in some tumors.
- 5. Thyroid Lymphography
- It showed round filling defects in the reticular structure, regular edges, and surrounding lymph nodes developed intact.
Thyroid adenoma diagnosis
- The diagnosis of thyroid adenoma is mainly based on medical history, physical examination, isotope scanning, and B-mode ultrasound.
Differential diagnosis of thyroid adenoma
- Nodular goiter
- Thyroid adenoma is mainly distinguished from nodular goiter. Although the latter has a single nodule, the thyroid gland is generally enlarged, which is easy to identify in this case. In general, a single nodule of an adenoma is still single for a long time, and nodular goiter often becomes multiple nodules after a long course of disease. In addition, nodular goiter is mostly diagnosed in goiter endemic areas, and thyroid adenomas are mostly diagnosed in non-endemic areas. Pathologically, a single nodule of a thyroid adenoma has a complete envelope and is well demarcated. Nodular goiter has no complete envelope in a single nodule, and the boundaries are unclear.
- 2. Thyroid cancer
- Thyroid adenoma should also be distinguished from thyroid cancer, which can be manifested as hard thyroid nodules, uneven surfaces, unclear borders, cervical lymphadenopathy, and accompanied by hoarseness, Horner syndrome, and so on.
Thyroid adenoma treatment
- According to the clinical manifestations and the patient's willingness to make treatment choices, close observation or surgical treatment can be selected.
Prognosis of thyroid adenoma
- Thyroid adenoma is a common benign tumor of the thyroid that can be cured after resection without special treatment and follow-up. The prognosis is good and occasional recurrence can be treated with surgery.