THYROID AND PARATHYROID SURGERY

  • OVERVIEW

A thyroid nodule is an abnormal growth within the thyroid gland. Thyroid nodules are very common and most often are benign (non-malignant). Each thyroid nodule should be evaluated by an expert for risk profiling. Northwest Cancer Hospital provides the necessary expertise for the proper evaluation of thyroid nodules, including radiographic and pathologic testing.

Fine needle aspiration cytology (FNAC) is a method by which a small amount of liquid from the nodule is sampled using a very small and thin needle. We provide this service at Northwest Cancer Hospital (NCH).

USG-guided FNAC is performed for greater accuracy and for nodules that are not palpable. The surgeons at NCH are certified in USG-guided FNAC and have vast experience in performing these procedures.

  • OVERVIEW

Important nerves are at risk during any surgery related to the thyroid and parathyroid glands. Preserving the function of these nerves is one of the most important aspects of thyroid and parathyroid surgery, which allows the preservation of the normal voice quality. Aside from care from the surgical team, intra-operative nerve monitoring (IONM) is an important tool for monitoring and preserving the functioning of these nerves. It is especially help in re-operations in this area, as it helps in identifying the nerves. The team at NCH routinely uses IONM for our thyroid and parathyroid surgeries.

  • OVERVIEW
  • SYMPTOMS
  • TREATMENT

The parathyroid glands are small glands that lie in close proximity to the thyroid gland, routinely 2 on the right side and 2 on the left side for a total of 4 glands. Certain people can be born with a lesser or more amount of parathyroid glands. They are normally associated with maintaining a balance of Calcium in the body.

Patients with parathyroid tumours have a calcium imbalance that is called primary hyperparathyroidism. Patients with tumours of the parathyroid glands frequently are asymptomatic. They are found to have an elevated calcium level on routine blood tests and then found to have a tumour. Before blood tests became more common, parathyroid tumour patients presented with the classic ‘stones, groans and bones’ complaints i.e. kidney stones, abdominal pain and bone pain, all from calcium imbalance and deposition in different organs. The vast majority of parathyroid tumours are benign (non-cancerous). Cancerous parathyroid tumours are more common in men.

The treatment of parathyroid tumours is surgery. Traditionally all four parathyroid glands were explored to locate the tumour. Today, there are many sophisticated techniques which are used in combination to localize the tumour prior to surgery. At NCH, we also use rapid PTH as well as frozen section to confirm the removal of the appropriate gland with the tumour.

  • OVERVIEW

Depending on the size of the thyroid nodule, a hemi-thyroidectomy (where half of the thyroid gland is preserved) or total thyroidectomy is recommended. Depending on the spread to adjoining lymph nodes, or surrounding structures, those would need to be removed along with the thyroid as well. Meticulous surgery is the key to good outcomes in thyroid cancer.