Thyroid Gland Enlargement and Pain | Adenoma Thyroid | Lymph Nodes Enlargement

Question: Toxic adenoma of thyroid


A solitary toxic nodule or an adenoma manifests itself as rapid enlargement of thyroid gland, or enlargement of the associated lymph nodes, and pain in the region of the thyroid gland. These nodules are usually cystic or benign, or may simply be the largest solitary nodule of a multi – nodular goiter.

Symptoms of thyroid enlargement:

  • Weight loss with increased appetite.
  • Irritability, restlessness
  • Tremors or jerks
  • Breathlessness, palpitation
  • Vomiting, diarrhoea


  • Thyroid function tests – T3, T4, TSH
  • Chest/ thoracic inlet X-RAY
  • FNAC – to rule out malignancy
  • USG – to demonstrate whether the nodule is cystic or solid
  • Thyroid scan – to demonstrate whether the nodule is functioning or not.

Risk for malignancy:

  • Previous irradiation
  • Long standing iodine deficiency
  • Familial tendency


  • Sometimes spontaneously resolution occurs.
  • Other cases need to be rendered euthyroid. A toxic adenoma does not usually remit after a course of anti-thyroid drugs.
  • Surgical intervention is necessary in cases of carcinoma (cancer) or when there is pressure on the trachea or for cosmetic reasons.

What is your age? Symptoms?
Is there a family history?
What investigations have been done? And are any medications on?