Endocrine Surgery

Most adrenal tumors are benign (noncancerous) and nonfunctional (not associated with hormone production) and require no treatment. Patients with nonfunctional tumors can be monitored with periodic CT scans to ensure the tumors are not growing.

Adrenal tumors that become active, or “functioning,” tend to cause an overproduction of hormones. The most common functioning adrenal tumors produce several well-recognized conditions such as:

• Cushing’s syndrome occurs when cortisol – a hormone your body produces in response to stress – is overproduced. It can lead to weight gain, osteoporosis, hypertension, diabetes, weakness, and altered mood.
• Pheochromocytoma is a tumor that oversecretes norepinephrine and epinephrine (which affect heart rate, blood pressure, and metabolism). Overproduction of these hormones can lead to headaches, episodes of sweating, and palpitations.
• Hyperaldosteronism occurs when the tumor secretes aldosterone, which can lead to hypertension and low potassium levels.

Most hormone-secreting tumors require surgery. If cancer of the adrenal gland is suspected, an adrenalectomy (surgery to remove one or both adrenal glands) is usually necessary, and most often can be done laparoscopically (a minimally invasive surgical technique).

An abnormal enlargement of your thyroid gland is called a goiter. An enlarged thyroid can make it difficult to swallow or even to breathe.

In the U.S., overproduction or underproduction of thyroid hormones is a common cause of a goiter, as are thyroid nodules. A goiter can also be caused by insufficient consumption of iodine, a mineral needed for the body to produce thyroid hormones, although this is rare in the U.S., where iodine has been routinely added to table salt sold at the grocery store since the 1920s.

Surgery to remove part or all of the thyroid (thyroidectomy) is sometimes required to treat an especially large or symptomatic goiter.

Graves’ disease is a hyperfunctioning state of the thyroid gland. It is considered an autoimmune disorder where your body’s own immune system mistakenly attacks the thyroid gland, resulting in the overproduction of thyroid hormones (hyperthyroidism). This, in turn, can cause the thyroid gland to enlarge, resulting in a goiter.

Symptoms of Graves’ disease include heart palpitations, anxiety, tremors, high blood pressure, excess sweating, eye protrusion, and weight loss.

A thyroidectomy, or the surgical removal of the thyroid gland, is sometimes required to alleviate a patient’s symptoms.

Hyperparathyroidism is a common disorder that results from overgrowth of one or more of the four parathyroid glands that reside next to the thyroid gland. It causes the overproduction of parathyroid hormone (PTH) that in turn leads to loss of calcium from bone and increased calcium absorption in the intestine and kidney.

Possible consequences of hyperparathyroidism include kidney stones, osteoporosis, fatigue, muscle and bone pain, constipation, gastroesophageal reflux disease (GERD), depression, and decreased mental acuity.

Once a diagnosis of hyperparathyroidism is suspected due to high calcium and PTH levels in the blood, surgery to remove the affected glands is usually recommended.

Endocrine tumors of the pancreas are fairly rare. They are often found when a CT scan of the abdomen is performed for other reasons. Many of these tumors are benign, but some can exhibit malignant behavior. Sometimes they will secrete hormones that can cause symptoms of low blood sugar, peptic ulcer disease, rash, or diarrhea.

Some potential pancreatic tumors are called insulinomas, gastrinomas, glucagonomas, and VIPomas. Many of these tumors can be removed using a minimally invasive laparoscopic approach, but sometimes a more traditional “open” surgery is required.

Thyroid nodules are a solid or fluid-filled lump within the thyroid gland. The nodules are commonly discovered during a physical exam or when a radiologic study of the neck is performed for other reasons.

Most of these nodules are benign, but surgery to remove all or part of the thyroid gland may be required for large or cancerous nodules – or if the nodules are causing an overproduction of thyroid hormones.

Thyroid cancer is an abnormal growth on the thyroid gland that is malignant or cancerous.

To diagnose cancer, bloodwork, ultrasound, and often a fine needle biopsy are required. The ultrasound, specifically, can help identify whether cancer has spread to the lymph nodes. All can be performed in the office and can usually be accomplished at the time of your initial consultation.

If the biopsy indicates or confirms thyroid cancer, a thyroidectomy to remove part or all of the gland is usually necessary.