[The hyperfunctional thyroid nodule]. / Nodulul tiroidian hiperfunctional.

ABSTRACT

Authors report their experience of 22 years regarding 284 patients with hyperfunctional thyroidal nodules (279 operated), representing 12.4% of the 2,289 cases of thyroidal (875 hyperthyroid) diseases treated during this period. The diagnosis was established on the basis of the confrontation of the anamnestic symptomatology and of that found at the clinical examination--which confirmed the pure character of thyrotoxicosis by showing the presence of a thyroidal nodule--with the study of the global glandular function and the scintigram, completed with dynamic tests. Among the typical clinical and scintigraphic, usually severe, forms (with cardiothyreosis) may be distinguished asymptomatic or atypical forms (with dissociated or intermittent manifestations). The treatment of the toxic thyroidal adenoma is surgical, except some contraindications of a general order. The surgical treatment is aimed at achieving the permanent cure of the disease, without sequelae or functional and/or morphological relapses. The subtotal lobectomy (210 cases) is preferred as an exeresis procedure to the enucleoresection (45 cases). In most operated cases (93%) the immediate clinical and biological results were favourable.