Toxic Adenoma history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Patients with toxic adenomas typically present with signs and symptoms of thyrotoxicosis. Common symptoms include fatigue, unintentional weight loss, heat intolerance, diaphoresis, palpitations, anxiety, and nervousness. Specific areas of focus when obtaining a history from the patient of toxic adenoma include possibility of recent iodide exposure in any form that can provoke transient thyrotoxicosis in a pre-existing toxic nodule such as medication (e.g., amiodarone), radiocontrast dye, dietary supplements

History

Specific areas of focus when obtaining a history from the patient of toxic adenoma include:

• Possibility of recent iodide exposure—in the form of (can provoke transient thyrotoxicosis in a pre-existing toxic nodule)
  • Medication (e.g., amiodarone)
  • Radiocontrast dye
  • Dietary supplements

Symptoms

Patients with toxic adenomas typically present with signs and symptoms of thyrotoxicosis. Common symptoms of toxic adenoma include:

• Fatigue
• Unintentional weight loss
• Heat intolerance
• Diaphoresis
• Tremor
• Palpitations
• Diarrhea
• Anxiety
• Nervousness
• Irritability
• Difficulty with mental concentration
• Hair loss
• Women may experience
  • Oligomenorrhea
  • Amenorrhea<ref>
• Men may complain of
  • Decrease in libido
  • Erectile dysfunction
  • Gynecomastia<ref>

Less common

Rarely patients with a toxic adenoma may experience symptoms due to mass effect of adenoma itself

• Neck discomfort
• Mild dysphagia
• Odynophagia

Signs of thyrotoxicosis

• Tachycardia
• Systolic hypertension
• Hyperactive or fatigued demeanor
• Staring gaze and lag
• Brisk carotid upstrokes
• Hyperdynamic point of maximal impulse
• Systolic flow murmur
• Proximal muscle weakness
• Fine hand tremor
• Velvety or oily skin
• Hair thinning.