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Treatment of toxic adenoma and toxic multinodular goiter

Douglas S Ross, MD
Section Editor
David S Cooper, MD
Deputy Editor
Jean E Mulder, MD


Toxic adenoma and toxic multinodular goiter (MNG) are common causes of hyperthyroidism, second in prevalence only to Graves' disease. The prevalence of toxic nodular goiter increases with age and in the presence of iodine deficiency and may therefore be more common than Graves' disease in older populations in regions of iodine deficiency. Toxic adenoma and MNG are the result of focal and/or diffuse hyperplasia of thyroid follicular cells whose functional capacity is independent of regulation by thyroid-stimulating hormone (TSH). Twenty to 80 percent of toxic adenomas and some nodules of MNGs have somatic mutations of the TSH receptor gene that confers autonomous hyperactivity [1,2].

The treatment of toxic adenoma and MNG will be presented here. The clinical presentation, evaluation, and diagnosis of hyperthyroidism and of goiter, as well as the treatment of other causes of hyperthyroidism, are reviewed separately.

(See "Overview of the clinical manifestations of hyperthyroidism in adults".)

(See "Diagnosis of hyperthyroidism".)

(See "Disorders that cause hyperthyroidism".)

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Literature review current through: Oct 2017. | This topic last updated: Jun 21, 2017.
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