Ozaki O, Ito K, Manabe Y, Mimura T
Ito Hospital, Tokyo, Japan.
Jpn J Surg. 1988 Mar;18(2):146-51. doi: 10.1007/BF02471423.
Adenomatous goiter with hyperthyroidism is a rare disease entity in Japan. Over a five-year period, we operated on 20 patients with this disease. Pre-operatively, basal thyrotropin was not necessarily suppressed and the thyrotropin-binding inhibiting immunoglobulin activity, which had been recently measured in five patients, showed normal values. Uneven patches of cold areas were noted on 131I thyroidal scintigrams. Thyroid function tests carried out three years after surgery in one lobectomy case and in eleven subtotal thyroidectomy cases revealed hypothyroidism in seven, hyperthyroidism in two and euthyroidism in only three cases. These results suggest that the pathogenesis and clinical features of adenomatous goiter with hyperthyroidism are quite different from those of Graves' disease, and that routinely performing near-total thyroidectomy may be considered as the treatment of choice.
伴有甲状腺功能亢进的腺瘤样甲状腺肿在日本是一种罕见的疾病实体。在五年时间里，我们对20例患有这种疾病的患者进行了手术。术前，基础促甲状腺激素不一定被抑制，最近对5例患者检测的促甲状腺激素结合抑制免疫球蛋白活性显示为正常值。在131I甲状腺闪烁扫描图上发现有不均匀的冷区斑块。在1例肺叶切除术病例和11例甲状腺次全切除术病例术后三年进行的甲状腺功能检查显示，7例出现甲状腺功能减退，2例出现甲状腺功能亢进，只有3例甲状腺功能正常。这些结果表明，伴有甲状腺功能亢进的腺瘤样甲状腺肿的发病机制和临床特征与格雷夫斯病有很大不同，常规进行近全甲状腺切除术可被视为首选治疗方法。
