Plummer's Disease is a condition where there is a single hyperfunctioning nodule producing excess thyroid hormone. Henry Plummer in 1913 described a clinically distinct form of thyrotoxicosis due to solitary or multiple toxic nodules in the thyroid. I restrict the term to a solitary a toxic nodule. This nodule is an adenoma (a benign tumour).
The clinical features of a patient with Plummer's Disease are similar to a patient with Toxic Multinodular Goitre except that there is usually only one nodule. The nodule is not always readily palpable.
After clinical suspicion, the following investigations are performed:
1. Free T3 and T4 LevelsIn classical cases, both T3 and T4 are elevated
2. Serum TSH LevelsSerum TSH levels are classically suppressed.
3. Radioactive Iodine or Technetium ScanThis shows a solitary nodule of uptake often known as a 'hot' nodule.
The treatment of choice is either Radioactive Iodine (131-I) or surgical excision.