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TOXIC ADENOMA – OPTIMAL EXTENT OF THYROIDECTOMY

Toxic adenoma is a single, autonomously hyperfunctioning follicular thyroid adenoma (nodule) causing hyperthyroidism (biochemical / clinical).

Selection of the extent (type) of thyroidectomy in patients with toxic adenoma should be based on the results of preoperative thyroid ultrasonography.

I.In the presence of contralateral nodule(-s) with suspicious ultrasonographic features or that will necessitate further surveillance in the future, total thyroidectomy is the procedure of choice.

II.When the toxic adenoma is the only lesion detected on thyroid ultrasonography, more limited thyroid resections are appropriate. Lobectomy removes the thyroid lobe where the toxic adenoma is located, while leaving normal thyroid tissue, allowing residual normal thyroid function in the majority of patients.

III.For isolated toxic adenomas, located in the isthmus, isthmusectomy is an accepted alternative.

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