Abstract
Toxic adenomas are characterized by a single hyperactive nodule in the thyroid leading to clinical and biochemical thyrotoxicosis. Autonomous or toxic adenomas are considered to originate from somatic mutations in the gene of Gs alpha protein or the gene of the thyrotropin receptor. In toxic adenoma only a hot nodule is visible on the thyroid scan. The frequency of toxic adenoma in patients with hyperthyroidism ranges between 1.5 and 44.5%. The possibility of developing thyrotoxicosis in a patient with a hot nodule with a diameter of 3 cm or larger is 20% in 6 years. This risk is substantially less for smaller nodules. Also, older patients with a hot nodule are more likely to become toxic as compared with younger patients. Definitive treatment consists of surgical removal of the nodule, administration of 131I, or percutaneous administration of ethanol into the nodule. The likelihood of malignancy in a toxic nodule is very low.
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