PLUMMER THYROID ADENOMA: BACK TO THE BASIC

Abstract

Plummer disease of the thyroid represents a traditional condition causing primary hyperthyroidism. Our aim is to introduce a short overview regarding the use of the term “Plummer adenoma” of the thyroid and to report a case with traditional diagnosis. In terms of method this is a case report and a historical data report using as references PubMed and online sites of general endocrine and historical information. This is a 43-year old female who had 2 months ago a mild episode of vertigo, followed by intermittent sweating and weight loss (2 kilos within 2 months). Hyperthyroidism is confirmed based on suppressed TSH. Thyroid scintigrame was performed using as thyroid tracer Tc99 Perthechnetate which revealed thyroid with normal anatomy with a “hot” autonomous nodule at the level of right thyroid lobe. Thyroid ultrasound showed a right lobe of 2.4 by 3.2 by 3.5 cm and a left lobe of 1.1 by 0.8 by 3.6 cm. Right lobe has a macronodule of 3.5 by 2.1 by 2.8 cm which entirely occupies the lobe; it has an inhomogeneous pattern, with microcalcifications and tracheal effect to the opposite site. The patient was offered daily thiamazole and a low dose of beta blockers; follow-up is necessary; then the indication of thyroidectomy will be done because of thyroid dimensions and nodule aspect in association with tracheal effect. Plummer toxic nodule of the thyroid represents a classical endocrine condition which requires thyroid scintigrame to be adequately identified even the management is not distinctive from other forms of primary hyperthyroidism.

Keywords

• plummer adenoma
• toxic goitre
• hyperthyroidism