Thyroid Surgery

Thyroid Diseases

	Thyroid nodules
	Thyroid cancer including papillary, follicular, Hurthle cell, medullary, and anaplastic thyroid cancer
	Goiter
	Substernal goiter
	Hyperthyroidism
	Graves' Disease
	MEN2A Syndrome
	MEN2B Syndrome
	Familial Medullary Thyroid Cancer

The thyroid gland is a butterfly-shaped gland located in the center of the neck, in front of the trachea (windpipe). The thyroid has a left and a right lobe and uses iodine to make hormones which help regulate body metabolism, temperature, heart rate, and growth rate. Thyroidectomy, or removal of a portion of the thyroid gland by surgery, consists of removal of one side of the thyroid (thyroid lobectomy) or all of the thyroid (total thyroidectomy). Thyroid function can be replaced by an oral thyroid hormone medication that is well tolerated.

Thyroid Nodules
Thyroid nodules are a common disorder, and less than 5% of all thyroid nodules are malignant. Our preferred method to evaluate a nodule is through a fine-needle aspiration biopsy. This procedure may be performed during a clinic visit. When cancer is suspected to be in a nodule, surgery is recommended.

Thyroid Cancer
Thyroid cancer can be divided into the well-differentiated types (papillary and follicular), medullary thyroid cancer and anaplastic thyroid cancer. The most common are the well-differentiated forms, which generally have an excellent prognosis. Typically, they are treated with a combination of surgery, radioactive iodine, and thyroid suppression. The less common types of thyroid cancer can be very aggressive. Specialized surgical expertise in the thyroid is essential for management of all these patients. Some thyroid cancers can be inherited. The RET proto-oncogene is a gene which causes medullary thyroid cancer when it contains certain mutations. Yale Endocrine Surgery can arrange for a patient to be screened for the presence of this mutated gene by Yale Cancer Center Genetic Counseling Service.

Goiters
Goiters are generally caused by non-malignant enlargement of the thyroid gland. They can become quite large and cause neck discomfort. If they become large enough, they can interfere with swallowing and can obstruct the trachea. Some of these goiters can extend into the chest and are known as substernal goiters.

Hyperthyroidism
Hyperthyroidism (overactive thyroid) may cause weight loss, increased nervousness, tremors, and palpitations, and usually affects previously healthy individuals. Some types of thyroid diseases are accompanied by eye disorders which cause protrusion of the eyes and sometimes threaten vision. Treatment options for hyperthyroidism are medication, radioactive iodine administration, surgery, or a combination of these treatments. Graves' disease is a common condition which causes hyperthyroidism.