Tirotoksicheskaya adenoma (Plummer's disease)
Tirotoksicheskaya adenoma – Elite Treatment in Europe
Tirotoksicheskaya Plummer adenoma or disease – a benign cancer of the thyroid gland, leading to increased levels of thyroid (thyroid) hormones in the body, due to increased production of cell adenoma. At the same time the body develops a special state – gipertiroz (hyperthyroidism), leading to an excess of hormones triiodothyronine (T3) and thyroxine (T4) levels. They, in turn, by a mechanism of negative feedback block the production of pituitary thyroid stimulating hormone (TSH), which regulates the normal functioning of the thyroid gland. More common in women, but the disease is common among men (at least 4 times), and among children.
For the disease characterized by communication with geochemical provinces of iodine deficiency, ie where endemic goiter usually develops. In contrast to euthyroid nodular goiter, adenoma, usually of small size – 2-3 cm usually develops a site, but sometimes there are multisite variants.
Today, the main cause of BPH is considered tirotoksicheskoy mutation of the gene encoding the receptor for pituitary hormone tirotropnomu. It is believed that the mutant gene causes the accumulation of cAMP in the cell, regardless of the strength of the natural regulatory signals from the pituitary and thereby causes the thyroid gland to produce hormones continuously. Continuous stimulation of follicular epithelium leads to hyperplasia, but their malignancy is extremely rare (less than 2% of cases in adults and no more than 10% of cases in children).
Clinic tirotoksicheskoy adenoma is similar to the diffuse toxic goiter and includes the following classic symptoms:
- weight loss
- shortness of breath, weakness, drowsiness
- heart rate (sinus tachycardia, and sometimes atrial fibrillation)
- heat intolerance
The differences are in the slower development of the disease, less pronounced effects on the cardiovascular system and, as a rule, the larger the age of the patients. Changes in the skin and eyes – ophthalmopathy and dermopathy – not typical.
Diagnosis of adenoma tirotoksicheskoy
Diagnosis of the disease include:
- physical examination (the doctor can find the node in one of the lateral lobes gland)
- medical imaging (this is commonly used ultrasound of the thyroid gland, and radioisotope diagnosis). These methods allow you to specify the size, position, and functional activity of the detected node.
- laboratory study. Usually determined by the high content of triiodothyronine on the background of near-normal thyroxine and TSH decreased sharply. Sometimes determine the increase related proteins of iodine. Samples with T3 and thyroliberin negative.
Fine-needle biopsy of the studies provide little information because is not always possible to determine if this lack of significant neoplastic adenoma.
Treatment of adenoma tirotoksicheskoy
Surgical treatment. In the case of severe hyperthyroidism before surgery treats thyrostatics. Patients of older age groups (over 40 years) usually is the treatment of radioactive iodine or alcohol injections directly into the area of adenoma by ultrasound. In the surgical treatment of the remote host is subjected to careful histological examination.
Sometimes it is possible and the spontaneous cure of the disease due to hemorrhage into a knot. Prognosis for goiter tirotoksicheskom favorable in most patients. The situation can only complicate the detection of malignant transformation, but, as already mentioned, this situation is rare.
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