Explore This Program

About the Program

The endocrine surgery team at Massachusetts General Hospital provides expert diagnosis and state-of-the-art treatment for diseases of the thyroid, parathyroid, and adrenal glands (endocrine diseases). Our program is one of the largest in the nation, with highly trained specialists who perform over 1,000 endocrine surgery procedures every year. 

We are a multidisciplinary team of physicians providing comprehensive care for a wide range of complex endocrine diseases, including benign and malignant tumors and recurrent and advanced cancer. Our team includes endocrinologists, surgeons, medical oncologists, radiologists, and pathologists to ensure that a comprehensive assessment and personalized treatment plan is made for every patient. 

Diseases We Treat

Endocrine diseases affect the thyroid, parathyroid, and adrenal glands, all of which produce essential hormones for the body to use in various ways. Our highly specialized team has extensive experience in the evaluation and management of common and complex thyroid, parathyroid, and adrenal conditions. 

Thyroid Disorders 

The thyroid gland is a butterfly-shaped gland located at the front of the neck. The hormone that it produces controls the body’s process of converting food into energy (metabolism) and is essential for growth and development as well as cardiac and bone function. 

The following thyroid disorders can be surgically treated by our endocrine surgery team at Mass General. 

Thyroid Cancer

Thyroid cancer is classified as either well-differentiated, when cancer cells appear similar to healthy thyroid cells, or poorly differentiated, when cancer cells do not look or behave like other cells. 

We treat all thyroid cancers including: 

  • Papillary: This is the most common type of thyroid cancer and arises out of the “well-differentiated” cells. It often grows slowly. 
  • Follicular: This is the second most type of thyroid cancer. It also arises out of well-differentiated cells.
  • Medullary: This represents an uncommon form of thyroid cancer originating from neuroendocrine "C-cells," which may be associated with an inherited syndrome but not in all cases. 
  • Anaplastic: This is the most rare and aggressive type of thyroid cancer. It requires a multidisciplinary team approach.

Our team expertly treats all stages of thyroid cancer—cancer that has spread to other parts of the body (metastatic), cancer that returns after remission (recurrent), and advanced thyroid cancer. We see complex patients in our multidisciplinary Advanced Thyroid Cancer clinic.

Hyperparathyroidism

Hyperthyroidism is an over-activity of the thyroid gland that results in too much thyroid hormone in the bloodstream. The two most common causes of hyperthyroidism are: 

  • Graves’ disease, an autoimmune disorder 
  • Toxic nodules, non-cancerous growths in the thyroid 
Thyroid Nodules

Thyroid nodules are common growths in the thyroid that can be benign (non-cancerous) or malignant (cancerous). They may need to be removed if cancer is suspected, if the nodule is secreting excess thyroid hormone (known as a hot nodule), or if they are causing symptoms, such as compression in the neck that makes breathing and swallowing difficult. 

If a thyroid nodule meets the criteria for biopsy, a biopsy can be performed at the Mass General Brigham Thyroid Biopsy Clinic at Newton-Wellesley Hospital. This multidisciplinary clinic brings together endocrinologists, thyroid surgeons, and cytologists in one location. The clinic is intended to provide up to date, streamlined care to patients, along with dedicated evaluation and fine-needle aspiration for thyroid nodules. 

Thyroid Goiter

A thyroid goiter is an enlarged thyroid gland. Thyroid glands with multiple benign thyroid nodules may also be referred to as a multinodular goiter. Depending on the size and cause of the overgrowth, symptoms, such as compression in the neck or secretion of excess thyroid hormone, it may require surgery. 

Parathyroid Disorders 

The parathyroid glands are four pea-sized glands located in the neck next to the thyroid gland. The hormone produced by the parathyroid glands plays a key role in regulating calcium, phosphorous, and vitamin D levels in the blood. 

The following parathyroid disorders can be surgically treated by our endocrine surgery team at Mass General. 

Hyperparathyroidism

Primary hyperparathyroidism is an over-activity of the parathyroid gland(s) resulting in elevated calcium levels in the blood. High calcium levels can lead to other problems in the body, such as kidney stones and bone thinning. Our team has expertise in determining whether you have surgically correctable disease and treatment.  

Parathyroid

Parathyroid tumors are rare growths inside the parathyroid gland(s). Most parathyroid tumors are noncancerous (benign). Parathyroid cancer can be treated by our multidisciplinary surgical team

Adrenal Disorders 

The adrenal glands are small glands located at the top of the kidneys that produce many important hormones that regulate several bodily functions including metabolism, blood pressure, and response to stress. 

The following adrenal disorders can be surgically treated by our endocrine surgery team at Mass General. 

Adrenal Nodules 

Adrenal nodules can be detected on imaging studies for other diseases and can be functional (cancerous) or non-functional (non-cancerous, as it does not produce hormones). Our multidisciplinary group can help determine if you need to have an adrenal nodule removed.  

Our Adrenal Nodule/Secondary Hypertension Clinic is a multidisciplinary group of primary care physicians, endocrinologists, and surgeons that will evaluate and triage patients with incidentally found or functional adrenal nodules/tumors. 

Adrenal Cancers 

We treat a full range of both primary adrenal cancer (those that arise from the adrenal gland) and secondary adrenal cancer (those that spread to the adrenal glands from other organs). Primary adrenal cancer is a rare form of cancer treated by a multidisciplinary team of endocrinologists, surgeons, and medical oncologists, all of whom are expert in evaluating and treating all types of adrenal tumors.  

Functional Adrenal Tumors and Nodules

Functional adrenal tumors and nodules are often non-cancerous (benign). Functional growths result in overproduction of adrenal hormones and may lead to: 

  • Cushing’s disease (also known as hypercortisolism), which occurs when the body produces too much cortisol, a hormone related to the body’s stress response. 
  • Primary hyperaldosteronism, which occurs when the adrenal glands produce too much aldosterone, the hormone responsible for balancing potassium and sodium. 
  • Pheochromocytoma, a rare tumor that can form in the adrenal glands. 
  • Sex-hormone-secreting tumors, which are tumors that produce estrogen, progesterone, or testosterone, resulting in behavior changes. 
Inherited Syndromes

Certain uncommon inherited syndromes, such as multiple endocrine neoplasias, have a familial tendency and can affect multiple endocrine organs. Our team is well-versed in assisting patients and their families in securing accurate diagnoses, conducting genetic testing and counseling, and providing treatment for these rare diseases.

Endocrine Surgical Treatments We Perform

Our surgeons perform a range of endocrine procedures to treat thyroid, parathyroid, and adrenal disorders. 

Thyroid 

Thyroid Ultrasound and Fine Needle Aspiration

Thyroid nodules are very common. They are most often found through a physical exam or incidentally with imaging for other diseases. When a thyroid nodule is discovered, your provider may recommend that you undergo a thyroid ultrasound and fine needle aspiration. This is a minimally invasive procedure used to remove a small tissue sample from a nodule found within the thyroid gland. The sample undergoes analysis in the laboratory to determine and test for the presence of cancer. This technique can also be used for specialized molecular and gene expression profiling. 

If a thyroid nodule meets the criteria for biopsy, a biopsy can be performed at the Mass General Brigham Thyroid Biopsy Clinic at Newton-Wellesley Hospital. This multidisciplinary clinic brings together endocrinologists, thyroid surgeons, and cytologists in one location. The clinic is intended to provide up to date, streamlined care to patients, along with dedicated evaluation and fine-needle aspiration for thyroid nodules. 

Thyroid Radiofrequency Ablation

Thyroid radiofrequency ablation (RFA) is a minimally invasive thermal technique involving the precise delivery of targeted energy into a thyroid nodule through a thin needle-like electrode. The electrode is guided through the nodule, administering controlled heat that causes the nodule to break down, leading it to decrease in size without harming the surrounding thyroid tissue. RFA is particularly effective for treating symptomatic or cosmetically bothersome benign thyroid nodules that are overactive. Unlike conventional thyroid surgery, which requires general anesthesia and results in scarring, RFA is performed through a small skin puncture under ultrasound guidance. Please call 617-643-3421 to refer a patient for thyroid radiofrequency ablation. 

Thyroid Lobectomy

A thyroid lobectomy is the removal of half of the thyroid gland (one lobe) and the tissue that connects the thyroid lobes (isthmus). It is most often used to treat thyroid cancer, thyroid nodules, and conditions causing an overproduction of the thyroid hormones, such as hyperthyroidism. 

Total Thyroidectomy

A total thyroidectomy is the removal of the entire thyroid gland. This procedure is most often used to treat thyroid cancer, or it may be recommended for other conditions that are unable to be treated using other techniques. 

Sistrunk Procedure

A Sistrunk procedure is done to remove thyroglossal duct cysts, which are small, soft lumps that form in the throat, typically at birth (congenital). Thyroglossal cysts are very rare and usually benign.  

Learn what to expect for total thyroidectomy 

Lymph Node Removal

A lymphadenectomy, or removal and dissection of the lymph nodes, is done for patients who have recently been diagnosed with certain types of cancers that are likely to spread to the lymph nodes. By studying the lymph nodes closest to the tumor, your care team can learn if the cancer has spread beyond the tumor and, if so, how far it has spread. This will help to determine the best approach for treating and preventing further spread of the cancer. Our endocrine surgeons have extensive experience in performing lymph node removal, also called neck dissections. 

Parathyroid 

Parathyroidectomy

A parathyroidectomy is the removal of the parathyroid gland. At Mass General, our endocrine surgery team performs parathyroidectomies through both minimally invasive techniques, such as entering through the mouth so that an incision is not needed, and traditional techniques, such as four-gland exploration. This procedure is most often used to treat hyperparathyroidism, parathyroid nodules, and parathyroid tumors. 

Learn what to expect for parathyroidectomy 

Adrenal  

Robotic Adrenalectomy

Robotic adrenalectomy is a minimally invasive approach that uses small incisions and tools to remove an adrenal gland if it is cancerous or producing too much adrenal hormone. A minimally invasive approach to adrenalectomy means less pain after surgery, faster recovery times, minimal scarring, shorter hospital stays, and more. Using our robotic surgical system, our surgeons can ensure surgical precision. Robotic surgery enhances your surgeon's ability to clearly visualize the surgical site and operate using a stable, computer-guided tool. 

Laparoscopic Adrenalectomy

A laparoscopic adrenalectomy is a minimally invasive approach that uses small incisions and tools to remove an adrenal gland if it is cancerous or producing too much adrenal hormone. A minimally invasive approach to adrenalectomy means less pain after surgery, faster recovery times, minimal scarring, shorter hospital stays, and more. 

Open Adrenalectomy 

Although the majority of adrenal surgery can be performed laparoscopically, large and/or advanced tumors sometimes require a larger incision to remove the tumor along with surrounding tissue and organs. Our surgeons have a wide range of experience in performing open procedures. 

What to Expect at Mass General

Patients and referring physicians will work with an experienced care coordinator to assess the patient’s needs and schedule appointments and tests. Our goal is to schedule the first appointment within one to two weeks of the initial request. In order to expedite the scheduling process, we encourage patients to confirm coverage options with their health insurance company and/or obtain a referral from their primary care physician prior to their first visit. Please call 617-643-7359 to start the process.

At your first appointment, you will meet with one of our experienced surgeons who will create a personalized treatment plan for you. They will continue to lead your care. As part of your assessment, we will review your medical history, symptoms, and any imaging and laboratory results. We may also perform an ultrasound and/or ultrasound-guided biopsy. Once a diagnosis has been confirmed, your surgeon will coordinate your care plan with the other members of your endocrine surgery care team. 

If you require surgery, your procedure will be scheduled at one of our locations, depending on availability and patient preference—Mass General (Boston), Newton-Wellesley Hospital (Newton, MA) or Mass General North Shore Center for Outpatient Care (Danvers, MA). The same Mass General team treats patients at all three locations. We are typically able to schedule patients for surgery very quickly. 

Innovative Research

The incidence of thyroid cancer is increasing, making research in this area and other endocrine disorders vital. We invest in research through our basic science laboratories, health services research programs, tissue bank, clinical endocrine database and ongoing clinical trials, encouraging collaborative research studies among surgeons, pathologists, oncologists and endocrinologists at Mass General. Our research focuses on innovation and outcomes, and leverages our institutional experience.

Investing in Future Leaders

We are committed to educating up-and-coming clinicians specializing in endocrine surgery. Our Endocrine Surgery Fellowship is dedicated to developing independent, skilled surgeons with a wide range of academic interests.

Our annual continuing medical education (CME) course, Surgery of the Thyroid and Parathyroid Glands, has been attended by surgeons and endocrinologists from around the world for nearly two decades.

Surgical Outcomes & Performance

The Center for Outcomes & Patient Safety in Surgery (COMPASS) ensures that surgical data is transparent and accessible for patients. Watch the video to view Mass General's performance for procedures to treat conditions of the adrenal, thyroid and parathyroid glands.


Additional Resources for Patients

Patients undergoing endocrine surgery at Mass General are welcome to use these resources in order to review answers to frequently asked questions, access important health information, and prepare for both the day of surgery and post-operative recovery.

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FAQs About Calcium Supplementation

FAQs About Calcium Supplementation

Read answers to questions about calcium supplementation in relation to endocrine surgery.

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What to Expect: Hemi-thyroidectomy Surgery

What to Expect: Hemi-thyroidectomy Surgery

Learn what to expect when recovering from hemi-thyroidectomy surgery.

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What to Expect: Parathyroid Surgery

What to Expect: Parathyroid Surgery

Learn what to expect when recovering from parathyroid surgery.

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What to Expect: Total Thyroidectomy

What to Expect: Total Thyroidectomy

Learn what to expect when recovering from total thyroidectomy.

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What to Expect: The Day of Endocrine Surgery

What to Expect: The Day of Endocrine Surgery

Learn what to expect when coming to Mass General for endocrine surgery.


Patient Story

Two days before her sophomore year of college, Grace Taylor learned that she had metastatic thyroid cancer. With the help of her Mass General care team, which was led by Dr. Antonia Stephen, she is now adapting to life as a cancer survivor. Her story was published by the Today Show.


Preparing for Thyroid Surgery

In this video, learn more about thyroid surgery and procedures, how to prepare for your surgery, the kind of questions you should ask your care team, and what to expect on the day of your operation.


American Association of Endocrine Surgeons

American Association of Endocrine Surgeons

View resources on endocrine surgery from the American Association of Endocrine Surgeons.

The Center for Endocrine Tumors

The Center for Endocrine Tumors

The Mass General Cancer Center treats benign & malignant endocrine tumors.

Thyroid Nodule Program

Thyroid Nodule Program

Read answers to frequently asked questions about thyroid nodules and goiters.


Frequently Asked Questions

How Do I Request an Appointment for Endocrine Surgery at Mass General?

You can request an appointment by calling our team at 617-643-7359. Our care coordinator will then answer any questions you may have and guide you through the process. 

Our goal is to schedule the first appointment within one to two weeks of the initial request. In order to expedite the scheduling process, we encourage you to confirm your coverage with your health insurance and/or obtain a referral from your primary care physician prior to your first visit. 

Why Would I Need Endocrine Surgery?

Endocrine surgery aims to treat disorders that affect the thyroid, parathyroid, and adrenal glands. These glands release hormones into the bloodstream for the body to use in various ways—the thyroid glands release hormones to regulate your metabolism, the parathyroid glands release hormones to regulate calcium, vitamin D, and phosphorous levels, and the adrenal glands release hormones to regulate stress and reproductive health. Your doctor may recommend endocrine surgery to treat a diseased or malfunctioning gland. 

What Is the Thyroid Gland and its Function?

The thyroid gland is shaped like a butterfly; the lobes of the thyroid look like wings and the connecting piece between the lobes (isthmus) looks like the butterfly’s body. The thyroid gland sits on top of and to the sides of the windpipe (trachea) just above the collar bone. 

The thyroid gland produces hormones that are essential for growth and development, energy metabolism, and normal cardiac and bone function. When your thyroid is under-functioning (hypothyroid), you may feel cold and tired, and experience muscle aches, dry skin, and hair loss. When your thyroid is over-functioning (hyperthyroid), you may feel anxious and hot, involuntarily lose weight, feel palpitations and rapid heartbeat, and have a difficult time sleeping and breathing. 

What Are the Parathyroid Glands and Their Function?

The parathyroid glands are four pea-sized glands located in the neck behind the thyroid gland. The hormone produced by the parathyroid glands plays a key role in regulating the calcium levels in the blood as well as phosphorus and vitamin D levels. 

When your parathyroid gland is overproducing hormone (hypercalcemia), you may experience joint and bone pain, muscle aches and cramping, thirst and frequent urination, and fatigue. When your parathyroid gland is underproducing hormone (hypocalcemia), you may experience skin tingling, muscle cramping, dry skin, and confusion. 

What Are the Adrenal Glands and Their Function?

The adrenal glands are small, triangle-shaped glands located at the top of the kidneys. They produce many important hormones that regulate several bodily functions, including metabolism, blood pressure, and the body’s response to stress. 

The signs of a problem with the adrenal glands will depend on the condition and which hormone is being affected. You may experience metabolic symptoms such as involuntary weight gain or loss, fatigue, or weakness; symptoms related to the immune systems such as frequent sickness; or symptoms related to blood pressure such as high or low blood pressure. 

What Are Some Common Endocrine Disorders Treated with Surgery?

Conditions commonly treated by endocrine surgery are: 

  • Thyroid tumors (benign and malignant) 
  • Adrenal tumors (benign and malignant) 
  • Parathyroid cancer (benign and malignant) 
  • Hyperthyroidism 
  • Hyperparathyroidism 
  • Thyroid nodules 
  • Thyroid goiter 
  • Cushing’s disease 
What Happens if My Endocrine System Is Damaged?

Endocrine disorders indicate a hormonal imbalance, which is when the body is either over or underproducing a particular hormone. This imbalance could either be long-term or temporary. The symptoms will vary based on the glands that is affected and the hormone that is out of balance. Your care team will perform tests to check your hormone levels and determine if you have an endocrine disorder. 

If one is discovered, your Mass General endocrine team will work with you to create your personalized care plan to treat the disease.