RESUMO
Although the clinical picture of autonomous adenoma of the thyroid gland has been well known for a long time, a series of connections has in some cases been unclarified, and in other cases contradictory so far. This applies in particular to the relationships between the scintigraphic image and the metabolic balance of the autonomous adenoma. In 98 patiets aged from 21 to 70 years old (80 women, 18 men) with autonomous adenoma unequivocally verified by suppression or stimulation test, it was therefore investigated whether such connections can be demonstrated. The following could be established: 1. In patients with an autonomous adenoma, there is an established connection between the scintigraphy image, the thyroxine and triiodothyronine levels in the serum as well as the delta-TSH. In patients with scintigraphically compensated autonomous adenomas, the hormone levels are all in the euthyroid range. In patients with scintigraphically decompensated autonomous adenoma, the values of thyroid hormones are found in some cases in the euthyroid, and in other cases in the hyperthyroid range. 2. Scintigraphically decompensated autonomous adenomas always display a negative TRH test, whereas this may be negative and in other cases also postivie in scintigraphically compensated autonomous adenomas. The TRH test may be negative in compensated and in decompensated autonomous adenoma even in patients in whom the thyroid hormone values in the serum are in the euthyroid range. The TRH test thus does not permit evaluation of the current functional activity of the autonomous adenoma. It is furthermore unsuitable for delimitation of a compensated from a decompensated autonomous adenoma as well as for different diagnosis between a nodular goiter and a scintigraphically compensated autonomous adenoma. 3. There is a statistically established relation between the size of the autonomous adenoma, the age of the patient as well as the thyroid hormone values. Autonomous adenomas accordingly become larger with increasing age. The values of thyroid hormones increase and lead to corresponding alterations in the TRH test.
