Thyroid specialist Dr. Greg Randolph in the OR

Thyroid and Parathyroid Conditions and Treatments

Our team of world-class thyroid specialists treats a variety of thyroid and parathyroid conditions, including thyroid nodules, goiter, thyroid cancer, hyperparathyroidism, and Graves’ disease. To schedule an appointment, call 617-573-3954 today. Learn more about each condition below:

Voice Preservation in Thyroid Surgery

Surgery on the thyroid gland requires special attention and expertise because of its close proximity to the recurrent laryngeal nerves (nerves powering the vocal cords). If these nerves are damaged during thyroid surgery, a patient’s ability to speak, swallow, and breathe can be significantly affected. Our nerve monitoring program helps preserve the voice and decrease the chance of such complications.

Our unique nerve monitoring program requires highly trained technicians to monitor the nerve signals during thyroid surgery and communicate directly with surgeons to help prevent damage to the laryngeal nerves. 

Our program was established in 1998 and has since performed more than 3,500 successful cases. More information »

Thyroid Cancer

Thyroid cancer is one of the most common forms of cancer, occurring in 5 to 10 percent of thyroid nodules. With thyroid cancer, there are generally no symptoms other than a lump in the neck area. This lump may represent a thyroid nodule or an enlarged lymph node containing thyroid cancer. Some thyroid nodules with cancer cannot be felt on exam and are diagnosed with a needle biopsy. Cancerous thyroid nodules can sometimes invade surrounding structures, which can lead to changes in the voice, such as hoarseness, or problems with swallowing.

To treat thyroid cancer, surgery to remove the thyroid gland and any involved lymph node is usually recommended. Our surgeons are well prepared for all cases and can perform complex procedures with a low risk of complications.

Although the prognosis for most thyroid cancers is favorable, long-term follow up is needed with the surgeon and endocrinologist. More information »

Thyroid Nodule Workup and Surgery

Thyroid nodules are lumps in the thyroid that can be pretty common. Although the majority of thyroid nodules are benign, our physicians evaluate the significant thyroid nodule, as approximately 5 to 10 percent of thyroid nodules are cancerous. (In general, a thyroid nodule is considered “significant” if it is 1 cm or larger and/or presents concerning features on ultrasound.)

There is no medical treatment for thyroid nodules. If a decision is made that the thyroid nodule needs to be removed, surgical treatment is recommended. Large nodules are often removed for a number of reasons: 

  • May cause pressure symptoms and can lead to the formation of goiter
  • They can produce excess thyroid hormones 
  • Can prevent accurate assessment of the possibility of cancer

Our surgeons have special training in the preoperative, intraoperative, and postoperative management of thyroid nodules. More information »

Hyperparathyroidism

The most common problem related to the parathyroid glands is primary hyperparathyroidism (PTH). This occurs when one or more parathyroid glands become enlarged and independently produce excess PTH, a hormone secreted by the parathyroid glands. In this situation, the bones, where calcium is stored, are stimulated to release excess calcium into the blood stream and can lead to a number of medical issues such as kidney stones, bone pain, osteoporosis (loss of bone mass), and mood disorders.

Many patients are first diagnosed with PTH when routine blood tests show abnormally high levels of calcium in the bloodstream.

Surgery is the definitive treatment for primary hyperparathyroidism. Our surgeons are committed to excellence in the surgical management of parathyroid disease and were one of the first in New England to implement intraoperative PTH monitoring during surgery. More information »

Goiter

Goiter is an abnormally enlarged thyroid gland. Goiter tends to occur randomly, but it can also be associated with some medications and/or with other thyroid conditions.

Patients with goiter may notice a visible, cosmetic distortion of the neck, the sensation of a lump in the throat when swallowing, and/or actual difficulty swallowing. They may also have difficulty breathing due to compression of the windpipe. 

Our radiologists and thyroid surgeons work together to determine the best course of action based on their evaluations of the patient's goiter. More information »

Graves' Disease/Hyperthyroidism

Located in the lower portion of the neck, the thyroid gland produces thyroid hormones and is responsible for regulating the body’s metabolism. In patients with hyperthyroidism, the thyroid produces too much thyroid hormone, resulting in a variety of problems such as nervousness, palpitations, increased sweating, irritability, tremor, unintentional weight loss, insomnia, and headaches. Patients who also suffer from hyperthyroidism caused by Graves’ disease may experience a change in the appearance of the eyes.

Patients with hyperthyroidism are always initially treated with antithyroid drugs (methimazole and/or PTU), which inhibit thyroid hormone production by the thyroid gland. Sometimes beta-blockers are also prescribed to initially control the symptoms related to hyperthyroidism.

More definitive treatment options for hyperthyroidism include:

  • Radioactive iodine therapy: Used to destroy thyroid tissue and can be effective in achieving a cure for some patients with hyperthyroidism. Patients with eye findings in Graves’ disease and those with compression symptoms are often not candidates for this treatment.
  • Surgical treatment: May be considered if there are co-existing thyroid enlargement nodules, known eye disease, and/or a preference to avoid radioactive iodine. In patients with Graves’ disease or Toxic Nodular Goiter, the entire thyroid gland is usually removed. In patients with a Toxic Solitary Nodule, the surgeon usually removes half of the thyroid.

Our thyroid surgeons have special training and expertise in the surgical management of hyperthyroidism from the causes described. Using the latest surgical techniques, surgeons can safely remove either the entire gland or a portion of the thyroid to achieve a permanent cure of hyperthyroidism. More information »

Recurrent and Revision Surgery

Revision surgery for thyroid cancer is often challenging because of anatomic changes that occur following a patient's initial surgery.

Our surgeons offer some of the best care available for these cases. We use nerve monitoring technology to preserve voice function and to prevent postoperative breathing and swallowing issues. Intraoperative ultrasound is also available and is used to detect specific lymph node metastases. 

Because of our expertise and favorable published outcomes, our Division has one of the highest volume rates for revision surgery in the United States. More information »