Thyroid Disorders

You can find your thyroid gland right in the lower neck and just above the breastbone. Your thyroid gland is important because it produces hormones that regulate metabolism, namely T3 and T4. Your pituitary gland (the one in your brain) controls your thyroid gland by releasing Thyroid Stimulating Hormone or TSH.

Thyroid Nodules & Goitre

Thyroid nodules are quite common. Thyroid nodules will present as a lump in your neck that you can feel. Sometimes they are discovered when you have a medical test for another condition. About 5% of adults suffer from palpable thyroid nodules and 95% of thyroid nodules are generally benign. Patients who have thyroid nodules can still have normal thyroid function levels. The main reason you must be checked as soon as symptoms occur or the lump is discovered on ultrasound or X-ray is to know if the thyroid nodule is malignant. Thyroid nodules can be single or multiple. Goitre is the name given to an enlarged thyroid from whatever cause.

You may be a candidate for thyroid surgery if you have the following conditions:

  • Benign multinodular goitre
  • Grave’s disease
  • Toxic multinodular goitre
  • Retrosternal goitre
  • Thyroid cancer

Thyroid Cancer

There are four main types of thyroid cancer—papillary carcinoma, follicular carcinoma, medullary carcinoma, and anasplastic carcinoma. Papillary carcinoma is the most common type of thyroid cancer, while anaplastic carcinoma is a very rare form of thyroid cancer. Papillary cancer is slow growing and the survival is very good with surgery and radioactive iodine treatment for the majority of patients. This is very important to understand if your doctor has told you about this diagnosis after undertaking a needle biopsy of your thyroid nodule.

Parathyroid Disorders

The parathyroid glands are the size of a rice grain and sit around the butterfly shaped thyroid gland. There are usually 4 parathyroid glands and they secrete a hormone PTH, which acts on many organs including the stomach, bones and kidneys to increase the blood level of calcium.

Parathyroid Disorders

What is hyperparathyroidism?

Hyperparathyroidism happens when one or more of your parathyroid glands become overactive. This maybe due to a tumour in one of the parathyroid glands called a parathyroid adenoma or due to enlargement in multiple glands called hyperplasia. Parathyroid cancer is very rare <1/1000 cases.

Hyperparathyroidism results in elevation of your blood calcium level and can be asymptomatic and detected on a routine blood test or it can cause a number of symptoms. You may be at risk of hyperparathyroidism if you experience these symptoms: poor concentration, sleep disturbance, chronic fatigue, irritability, anxiety or depression, forgetfulness, kidney stones, gastric reflux/heartburn, high blood pressure, recurrent headaches, and non-specific aches and pains.

Significant complications from parathyroid disease include kidney stones and osteoporosis.

Surgery for primary hyperparathyroidism is straightforward in over 95% of cases when undertaken by an experienced parathyroid surgeon. If you are told you have the disease and not offered an operation by your GP and Endocrinologist, seeking an opinion from an experienced parathyroid surgeon is a reasonable request you can make to your doctors.

Adrenal Disorders

The adrenal glands are located on the top of both kidneys. These endocrine glands are small, triangle-shaped, and orange in colour with each gland consisting of a medulla and a cortex. The medulla produces the body’s epinephrine and norepinephrine (adrenaline), whilst the adrenal cortex is responsible for other hormones essential for salt and fluid regulation.

Dysfunction of the adrenal glands can typically manifest in the following ways:

  • A functionally overactive tumour that produces excess hormones
  • A functionally overactive tumour that produces excess hormones which can be measured on blood and urine tests, but without a full blown clinical syndrome
  • A functionally inert tumour, but one which is of sufficient size or exhibits other characteristics on imaging which make a cancer possible

Adrenal Gland Disorders which may require surgery, include:

  • Conn’s syndrome – retention of salt and water, loss of potassium and high blood pressure
  • Cushing’s syndrome – excess cortisol producing diabetes, hypertension, moon face, thin skin, and weight gain
  • Phaeochromocytoma – excess adrenaline and noradrenaline producing drenching sweats, high blood pressure, a racing heart and severe headaches
  • Primary cancers of the adrenal

Salivary Glands Tumours and Disorders

Salivary gland tumors are abnormal cells growing in the ducts that drain the salivary glands.

Alternative Names

Tumour – salivary duct

Salivary gland disorders can be caused by a variety of benign and malignant tumours. There are three major salivary glands: the parotid glands, the submandibular glands, and the sublingual glands. Aside from these major salivary glands, there are hundreds of mini salivary glands, which are located under the mucosa of the oral cavity.

The most common salivary glands inflammatory disorders are acute sialadenitis, chronic sialadenitis, and automimmune conditions like Sjoren’s syndrome.


Salivary gland tumours

If you have any lump or pain in any of your salivary glands, you might have a salivary gland tumour. Salivary gland tumours can be benign or malignant. The following are some of the salivary gland benign tumours: Warthin’s tumour, pleomorphic adenoma, monomorphic adenoma, and oncocytoma. Salivary gland malignant tumours include mucoepidermal carcinoma, metastatic cutaneous squamous cell carcinoma, adenocarcinoma, adenoid cystic carcinoma, adenocarcinoma, lymphoma, and acinic cell carcinoma.

If you have a lump in one of your salivary glands then your GP will organise a biopsy and refer you to an experienced salivary gland surgeon.