Among benign tumors of the thyroid gland, most often there is an adenoma. Nodular education is encapsulated and, in the absence of timely therapy, can become a malignant tumor.
In some cases, the adenoma of the thyroid gland develops secretively for a long time, in a part of the sick people the disease manifests itself as signs indicating hyperthyroidism.
About the disease
Thyroid adenoma is a node that has an elongated oval or round shape. Tumor growth starts from glandular cells.
The formation of a well-defined external fibrous capsule separating pathologically altered tissues from healthy ones.
The development of the adenoma occurs slowly, if the neoplasm reaches a sufficiently large size, then a number of structures are compressed.
Thyroid adenoma is almost 4 times more likely to be diagnosed in women over 40 years of age.
A growing tumor is the cause of changes in the functioning of the gland - the body begins to secrete more hormones, which in turn leads to a decrease in the pituitary gland and a decrease in the production of thyrotropin.
Code of disease according to ICD 10 - D34.In addition to thyroid adenoma, the group of these diseases includes cysts and nodes.
Classification of
Thyroid adenomas are classified according to their morphological structure. Allocate:
- Follicular species of adenomas.
- Papillary.
- Functioning( toxic).
- Light-celled
- Oxifil.
Follicular
This variant of the thyroid adenoma is revealed in most cases. The main patients are young people.
The name follicular adenoma is due to the fact that the tumor begins in the follicles. As you grow, it acquires a globular shape with a smooth capsule, when you feel it, the knot is fairly tight. The capsule, together with the tumor, easily shifts and this is noticeable when swallowing.
The follicular appearance of the adenoma, depending on the cells present in the node, is also divided into colloidal, trabecular, simple, fetal.
Most patients with histological examination confirm the good quality of atypical cells, but it must be remembered that 10% of patients are subsequently diagnosed with malignant degeneration.
Follicular adenomas do not produce hormones, and this leads to the fact that the neoplasm develops almost imperceptibly. At the initial stage can only be increased sweating, weight loss and increased drowsiness.
A large new tumor compresses the respiratory tract and esophagus, disrupting the functioning of these organs, and it is at this stage that patients usually come to the doctor.
For what reason the follicular adenoma develops, it was not possible to establish with accuracy. It is assumed that this type of tumor occurs due to the shortage of iodine in foods and water, in some cases the growth of the tumor is established after neck injuries.
The main treatment is surgical. After complete removal of the site, part of the tissue is taken for research, which results in the elimination or confirmation of the malignancy of the process.
Toxic
Toxic( functioning) adenoma or Plummer's syndrome-a diagnosis is made when one or more nodes producing excess hormones are diagnosed in the gland. Usually the tumor is small, but it is well probed.
Tumor growth is markedly increased when the amount of iodine in the total blood flow increases, this leads to an increase in the production of pituitary hormones.
Plummer syndrome manifests itself as signs of thyrotoxicosis - there are violations in the functioning of the cardiovascular and autonomic nervous systems.
Patient may be disturbed by shortness of breath, abdominal pain, increased anxiety, decreased or increased appetite. There is a double vision in the eyes, sensitivity to light increases, in advanced cases the eyeball protrudes.
Toxic adenoma can be the result of a gene mutation that leads to disruption of the pituitary gland. Among the causes of the disease, there is also a shortage of iodine, a hormonal imbalance in the body and a long-term effect of toxic substances.
Adenoma from Gurthel cells
The second name is the oncocyte adenoma. The disease in most cases is detected in patients from 20 to 30 years who have a history of autoimmune thyroiditis.
At the initial stage of development, there are no specific symptoms. Gradually, there may be signs of a decrease in the functioning of the thyroid gland.
Neoplasm is a brownish-yellowish tumor, often it shows individual hemorrhages.
Oncocytic adenoma is formed from several types of cells, in 10% -35% of cases cancer cells are found.
Papillary
The papillary form of the adenoma is a cyst-like tumor. Inside the neoplasm is a liquid dark-colored content, on the inner walls papillate growths grow.
Reasons for
Certain causes and one mechanism for their development are not established for all types of adenomas.
The main hypothesis of the disease is an increased secretion of thyroid-stimulating hormone, which is secreted by the pituitary gland.
Hyper secretion can be caused by genetic mutations. Adenomas of the thyroid gland are often found in patients with dysfunctions of the autonomic nervous system.
There are also a group of provoking factors, under the influence of which the risk of developing a tumor in the tissues of the thyroid gland increases:
- Living in areas with poor environmental conditions and where there is little iodine in the soil and water.
- Predisposition inherited.
- Prolonged exposure to the body of toxic substances, including those whose impact is related to professional activities.
- Failure in the hormonal system.
- Trauma of the thyroid and neck.
The probability of adenoma formation is significantly increased if the human body is affected by several provoking factors.
Symptoms of thyroid adenoma
The clinical picture of adenomas of the thyroid gland depends largely on whether there is an increased production of hormones.
The most toxic is the appearance of the formation, with other forms of gland adenoma, the symptomatology for a long time is either completely absent or is expressed by only a few subjective changes in the state of health.
To general signs of adenomas, which can be fixed even at the initial stages of their growth, include:
- Weight loss, not related to diets, changes in eating habits, other diseases.
- Increased sensitivity to excessively high ambient temperatures.
- Severe irritability and anxiety.
- Sweating at any time of the day.
- Increased fatigue and rapid onset of fatigue in normal physical activity.
- Periodic tachycardia.
As the tumor grows, there are other symptoms of the disease, with a large knot size, you can pay attention to:
- Pain in the lower third of the neck.
- Discomfort sensations in the throat, manifested by the sensation of a foreign object, perspiration, difficulty swallowing.
- Neck deformation. Periodic dry cough.
- Change the Voice Voice.
- Disturbance of respiratory function - dyspnea, difficulty in inhaling or exhaling.
Some patients can detect changes in the work of the digestive system, hypotension or vice versa, increasing blood pressure, raising the temperature to 37-37.5 degrees. Adenoma of the thyroid gland can provoke the development of disorders in the work of the heart, including atrial fibrillation.
Diagnosis
A preliminary diagnosis of a thyroid neoplasm is made after patient inquiry and examination.
When collecting an anamnesis, the doctor should find out all the complaints, the time of the appearance of the first disturbing symptoms.
When examined, it is determined whether there is a neck deformity, and with palpation, a dense tumor in the thyroid gland can be detected.
To confirm the diagnosis and identify the type of education, a number of examinations are mandatory, primarily:
- ultrasound. Scanning the thyroid gland allows you to locate a node, this method of diagnosis establishes the position of the tumor, its size, the degree of spread to surrounding tissues.
- Radioisotope scanning. The method is based on the absorption of the radioactive iodine by the thyroid gland. If the resulting node is active, releasing a large number of hormones, iodine accumulates much more in it than in healthy tissues. In the pictures such a node differs in color.
- Computer tomography or MRI is performed when a pre-made ultrasound has given little information or if the gland is located below the sternum.
- Puncture biopsy - sampling of the node fragment for histological examination. The fence is controlled by ultrasound and under anesthesia. This method of diagnosis allows you to establish the type of adenoma and the presence of cancer cells in the node.
- Blood tests. If there is a suspicion of a tumor in the thyroid gland, it is necessary to take blood for hormones - establish the level of thyroid hormones and thyroid-stimulating hormone of the pituitary gland. In the biochemical analysis of blood with increased function of the gland, metabolic disturbances are revealed.
Thyrotoxic adenoma leads to a disruption of the functions of the internal organs, so for such patients the survey plan is always selected individually.
Methods of treatment
Virtually any thyroid adenoma must be removed surgically. The exception applies only to colloid adenoma developing during pregnancy.
The operation is performed only after the thyroid gland functions in normal mode, that is, to select the desired amount of hormones. With thyrotoxicosis, this is achieved by taking a course of tirostatic agents - Thiamazole, Propicil, Carbimazole.
For the preoperative period, the doctor can recommend a vitamin-enriched and protein-enriched diet. At this time, a full-fledged sleep is important, the absence of psychoemotional shocks, phytotherapy is not banned. After diagnosing adenoma it will be necessary to refrain from visiting the solarium, under the ban and sunbathing.
Surgical treatment
After the patient is prepared, one of the surgical procedures is selected:
- Enucleation of the node - removal of only the adenoma along with its capsule. The operation is possible only if there are no signs of a malignant process, and the surrounding tissue node is not changed.
- The hemithyroidectomy is a resection of the affected half of the gland. This type of operation is chosen with a significant change in the organ and when there are signs that indicate the malignancy of the tumor.
- Subtotal resection of - cutting off most of the gland. There are only small parts in 4-6 mm in size from the right and left lobes. Later the patient will need hormones.
- Thyroidectomy is a complete removal of the thyroid gland. The operation is performed when there are signs that indicate a malignant process. The absence of the thyroid gland will not be strongly felt if the operated patient will take hormones throughout the rest of his life. During this operation, there is a risk of damage to the vocal cords.
If you identify absolute contraindications to surgery( especially for older patients) choose alternative treatment options:
- Therapy with radioactive iodine.
- Introduction to the unit of ethyl alcohol, which causes the death of cells, and the tumor gradually dies.
Folk remedies
Phytotherapy and other folk methods of treatment of thyroid adenomas are additional, but not the main ways to combat this disease.
Apply them in the preparatory period for surgery or during recovery from surgery.
It is always advisable to coordinate with the doctor an independent treatment, as some methods of treatment have contraindications.
It is usually prescribed decoctions and infusions of plants that can suppress the pituitary gland and, accordingly, reduce the production of hormones in the gland. These herbs include:
- Moss Icelandic.
- Drok dyeing.
- A medicinal herb.
- Red-breasted chapel.
- Volovik ordinary.
- Blackness. Comfrey
- .
Ways of using these herbs can be suggested by an endocrinologist or herbalist.
Prognosis and prevention of
If the diagnosis is made correctly at the initial stage of the adenoma and a timely operation is performed, then there will be no adverse health effects in the future.
When removing part or all of the gland will have to take certain hormones for life. In the event that the tumor is detected already at its large size, then the risk of detecting cancer cells increases. More dangerous and surgery during this period, since it can result in damage to ligaments and nerves.
After successful treatment it will be necessary to undergo an annual examination, to eat properly, vitaminized and rich in iodine food. It is desirable to abandon bad habits.