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| {{CMG}}; {{AE}} {{Ammu}} | | {{Thyroid adenoma}} |
| == Overview ==
| | {{CMG}}; {{AE}} {{Ammu}} {{RAK}} |
| A thyroid adenoma, or solitary thyroid nodule is a [[benign tumor]] of the [[thyroid]] gland.
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| ==Classification==
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| Almost all [[thyroid]] adenomas are follicular adenomas.<ref name="isbn0-7216-0187-1">{{cite book |author=Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. |title=Robbins and Cotran pathologic basis of disease |publisher=Elsevier Saunders |location=St. Louis, Mo |year=2005 |pages=1117 |isbn=0-7216-0187-1 |oclc= |doi= |accessdate=}}</ref> Follicular adenomas can be described as "cold", "warm" or "hot" depending on their level of function.<ref name="urlEndocrine Pathology">{{cite web |url=http://library.med.utah.edu/WebPath/ENDOHTML/ENDO037.html |title=Endocrine Pathology |format= |work= |accessdate=2009-05-08}}</ref> [[Histopathological]]ly, follicular adenomas can be classified according to their cellular architecture and relative amounts of cellularity and colloid into the following types:
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| *Fetal (microfollicular) - these have the potential for microinvasion.<ref name=Kelley2008/> These consist of small, closely packed follicles lined with epithelium.<ref>[http://medical-dictionary.thefreedictionary.com/microfollicular+adenoma TheFreeDictionary > microfollicular adenoma] Citing: Dorland's Medical Dictionary for Health Consumers. Copyright 2007</ref>
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| * Colloid (macrofollicular) - these do ''not'' have any potential for microinvasion<ref name=Kelley2008/>
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| * Embryonal (atypical) - have the potential for microinvasion.<ref name=Kelley2008/>
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| * Hürthle cell adenoma (oxyphil or oncocytic tumor) - have the potential for microinvasion.<ref name=Kelley2008/>
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| * Hyalinizing trabecular adenoma<ref>{{Cite journal | pmid = 21940281| year = 2011| author1 = Ünlütürk| first1 = U| title = Hyalinizing trabecular tumor in a background of lymphocytic thyroiditis: A challenging neoplasm of the thyroid| journal = Endocrine Practice| volume = 17| issue = 6| pages = e140–3| last2 = Karaveli| first2 = G| last3 = Sak| first3 = S. D.| last4 = Erdoğan| first4 = M. F.| doi = 10.4158/EP11138.CR}}</ref>
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| Papillary adenomas are very rare.<ref name=Kelley2008>[http://emedicine.medscape.com/article/850823-overview#aw2aab6b4 emedicine > Thyroid, Evaluation of Solitary Thyroid Nodule > Benign Thyroid Nodules] By Daniel J Kelley and Arlen D Meyers. Updated: Oct 17, 2008</ref>
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| ==Pathophysiology==
| | {{SK}}Colloid thyroid nodules; Colloid nodules (thyroid); Adenomatous thyroid nodule; Colloid nodule |
| A thyroid adenoma may be clinically silent, or it may be a "functional" [[tumor]], producing excessive [[thyroid hormone]]. In this case, it may result in symptomatic [[hyperthyroidism]], and may be referred to as a ''toxic'' thyroid adenoma. Careful [[pathology|pathological]] examination may be necessary to distinguish a thyroid adenoma from a minimally invasive [[thyroid cancer|follicular thyroid carcinoma]].
| | ==[[Thyroid adenoma overview|Overview]]== |
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| ===Morphology=== | | ==[[Thyroid adenoma historical perspective|Historical Perspective]]== |
| Thyroid follicular adenoma ranges in diameter from 3 cm on an average, but sometimes is larger (up to 10 cm) or smaller. The typical [[thyroid]] [[adenoma]] is solitary, spherical and encapsulated lesion that is well demarcated from the surrounding parenchyma. The color ranges from gray-white to red-brown, depending upon
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| # the cellularity of the adenoma
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| # the colloid content.
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| Areas of hemorrhage, fibrosis, calcification, and cystic change, similar to what is found in multinodular goiters, are common in thyroid (follicular) adenoma, particularly in larger lesions.
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| ==Causes== | | ==[[Thyroid adenoma classification|Classification]]== |
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| * Drug side effect: [[Pergolide]], [[Potassium iodide]]
| | ==[[Thyroid adenoma pathophysiology|Pathophysiology]]== |
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| ==Differentiating Thyroid adenoma from other Diseases== | | ==[[Thyroid adenoma causes|Causes]]== |
| A thyroid adenoma is distinguished from a [[multinodular goiter]] of the thyroid in that an adenoma is typically solitary, and is a [[neoplasm]] resulting from a genetic [[mutation]] (or other genetic abnormality) in a single precursor cell.<ref name="robbins">{{cite book |author=Ramzi Cotran, Vinay Kumar, Tucker Collins |title=Robbins Pathologic Basis of Disease, 6th Edition |year=1999 |publisher=W.B. Saunders |isbn=0-7216-7335-X |pages=}}</ref> In contrast, a multinodular goiter is usually thought to result from a [[hyperplasia|hyperplastic]] response of the entire thyroid gland to a stimulus, such as [[iodine deficiency]].
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| Careful [[pathology|pathological]] examination may be necessary to distinguish a thyroid adenoma from a minimally invasive follicular thyroid carcinoma.<ref name="robbins"/>
| | ==[[Thyroid adenoma differential diagnosis|Differentiating Thyroid adenoma from other Diseases]]== |
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| | ==[[Thyroid adenoma epidemiology and demographics|Epidemiology and Demographics]]== |
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| ==Management== | | ==[[Thyroid adenoma risk factors|Risk Factors]]== |
| Most patients with thyroid adenoma can be managed by [[watchful waiting]] (without surgical excision) with regular monitoring.<ref name=Welker2003/> However, some patients still choose surgery after being fully informed of the risks.<ref name=Welker2003/> Regular monitoring mainly consists of watching for changes in nodule size and symptoms, and repeat ultrasonography or [[needle aspiration biopsy]] if the nodule grows.<ref name=Welker2003>Treatment section in: {{Cite journal | last1 = Welker | first1 = M. | last2 = Orlov | first2 = D. | title = Thyroid nodules | journal = American family physician | volume = 67 | issue = 3 | pages = 559–566 | year = 2003 | pmid = 12588078}} [http://www.aafp.org/afp/2003/0201/p559.html]</ref>
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| | ==[[Thyroid adenoma natural history, complications and prognosis|Natural History, Complications, and Prognosis]]== |
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| ==References== | | ==Diagnosis== |
| {{Reflist|2}}
| | [[Thyroid adenoma diagnostic study of choice|Diagnostic Study of Choice]] | [[Thyroid adenoma history and symptoms|History and Symptoms]] | [[Thyroid adenoma physical examination|Physical Examination]] | [[Thyroid adenoma laboratory findings|Laboratory Findings]] | [[Thyroid adenoma electrocardiogram|Electrocardiogram]] | X-ray | [[Thyroid adenoma ultrasound|Echocardiography and Ultrasound]] | CT scan | [[Thyroid adenoma MRI|MRI]] | [[Thyroid adenoma other imaging findings|Other Imaging Findings]] | [[Thyroid adenoma other diagnostic studies|Other Diagnostic Studies]] |
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| | ==Treatment== |
| | [[Thyroid adenoma medical therapy|Medical Therapy]] | [[Thyroid adenoma surgery|Surgery]] | [[Thyroid adenoma prevention|Prevention]] | [[Thyroid adenoma cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Thyroid adenoma future or investigational therapies|Future or Investigational Therapies]] |
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| | [[Category:Projects]] |
| | [[Category:Oncology]] |
| | [[Category:Disease]] |
| | [[Category:Endocrinology]] |
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| [[es:Adenoma tiroideo tóxico]]
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| {{WH}} | | {{WH}} |
| {{WS}} | | {{WS}} |
| | | [[Category:Up-To-Date]] |
| [[Category:Disease]] | |
| [[Category:Oncology]] | | [[Category:Oncology]] |
| | [[Category:Medicine]] |
| [[Category:Endocrinology]] | | [[Category:Endocrinology]] |
| [[Category:Primary care]] | | [[Category:Surgery]] |
| [[category:Thyroid disease]]
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