The thyroid enlargement, non-toxic (previously called thyroid gland, non-toxic adenoma of) is the most common benign lesion in the thyroid. It is a solitary, enclosed nodule composed of cells that differ from the surrounding gland.

Most probably, adenomas result from small secretory cells that are benign in character, but grow more quickly. In addition, radiation treatment of the head and neck in childhood is associated with an increased prevalence of thyroid nodules and thyroid cancer in adult life.

Solitary nodules seldom grow large enough to extend below the sternum and cause pressure symptoms. If there is spontaneous bleeding into the capsule of the adenoma, then swelling and pain will be evident. These adenomas do not lead to thyroid cancer.

A needle aspiration for cell study is the most accurate test for the condition. A radioactive iodine (RAI) test is performed if the aspiration is suspicious for carcinoma. If the test suggests a cold nodule (a nodule less detectable than surrounding tissues), then surgery is strongly recommended because up to one in four may be malignant.

A thyroid hormone is given to suppress growth of the nodule. If nodules continue to enlarge on suppressive therapy, then surgical removal is recommended.

Eventually, approximately a quarter of patients will develop hyperthyroidism.

• Consider service connection on a presumptive basis as a chronic condition (38 CFR §3.307; §3.309(a)).
• Consider service connection on a presumptive basis as a condition associated with ionizing radiation exposure (38 CFR §3.307; §3.309(d); §3.311).

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