Endocrine Conditions

Dr. Castillo evaluates and treats diseases of the thyroid, parathyroid, and adrenal glands, utilizing advanced minimally invasive surgical techniques.

Thyroid Conditions

The thyroid gland is located in the lower neck, and produces hormones that regulate metabolism. Thyroid disease is very common and usually involves overactive or underactive glands that produce either too much or too little thyroid hormone.

Conditions that may require thyroid surgery include:

• A nodule or cyst on the thyroid
• An extremely overactive thyroid gland
• Thyroid cancer
• Benign thyroid tumors that are causing symptoms, such as difficulty swallowing or breathing

Symptoms of a thyroid condition can include:

• Fatigue
• Emotional problems
• Weight gain
• Weight loss
• Lump in the neck

Diagnosis

• Thyroid ultrasound: Painlessly uses sound waves to create an image of the thyroid gland and helps the physician to identify the size, location, and characteristics of nodules within the thyroid gland.
• Fine-needle aspiration (FNA) biopsy: After numbing the area with local anesthesia, Dr. Castillo inserts a fine needle into the lump and withdraws a small sample of tissue for examination. This test provides information to determine if a nodule is benign or malignant.
• CAT scan of the neck and chest - A CAT scan may be done to evaluate if an enlarged thyroid is pushing on the trachea or growing down into the chest area.

Treatment

Surgery is often recommended for patients with thyroid cancer or hyperthyroidism that is not relieved by medication. Dr. Castillo utilizes the most current and minimally invasive techniques to treat thyroid conditions. Those surgical techniques include:

• Thyroidectomy: The procedure involves removing the whole thyroid. It is done in a surgical facility under general anesthesia and most patients are able to go home the next day.
• Thyroid lobectomy: This procedure involves removing one side of the thyroid. It is performed in a surgical facility under general anesthesia and most patients are able to go home the same day.

Parathyroid Conditions

The four parathyroid glands are located in the neck, near the thyroid gland. They release the hormone that regulates calcium metabolism. Parathyroid hormone regulates levels of calcium in the bones and urine. Dr. Castillo provides minimally invasive surgical treatment to patients with disorders of the parathyroid glands.

Symptoms of a parathyroid disorder can include:

• Depression
• Fatigue
• Muscle cramps
• Confusion, memory loss
• Bone pain or fractures
• Heartburn (GERD)
• Heart palpitations, high blood pressure
• Kidney stones

Diagnosis

• Parathyroid ultrasound: Painlessly uses sound waves to create an image of the parathyroid gland. Normal parathyroid glands are generally too small to see on ultrasound, but abnormal parathyroid glands may be enlarged and easily seen by ultrasound.
• Sestamibi parathyroid scan: A safe radioactive agent is injected intravenously, and is absorbed by the overactive parathyroid gland. Only the overactive gland reacts to the agent. A gamma camera captures images that allow Dr. Castillo to identify which of the parathyroid glands is overactive.

Treatment

Surgery is the most common treatment for an overactive parathyroid gland. Calcium levels are difficult to control with medication, and calcium imbalance in the body is a serious condition. Too little calcium in the bones can lead to osteoporosis. Too much calcium in the blood can increase the risk of multiple medical problems.

Dr. Castillo uses the most minimally invasive techniques that will result in best cosmetic results while still enabling him to perform the most complete and thorough procedure.

Adrenal Conditions

The adrenal glands are located near the kidneys and produce hormones that are responsible for normal physiological functioning. If the adrenal glands produce too many or too few hormones, major problems occur. These hormones affect blood pressure, heart rate and sweating, water and glucose use in the body and some sex hormones.

Symptoms

Patients with adrenal disorders will exhibit a variety of symptoms depending upon the condition they have.

Pheochromocytomas: Symptoms include high blood pressure and can include headaches, excessive sweating, anxiety or panic attacks, and rapid heart rate.

Hyperaldosteronism: Aldosterone producing tumors cause high blood pressure and low potassium levels. In some patients this may result in symptoms of weakness, fatigue, headaches, muscle cramping, and frequent urination.

Cortisol producing tumors cause Cushing’s Syndrome, a condition characterized by upper body obesity, high blood sugar, high blood pressure, menstrual irregularities, skin problems like acne or stretchmarks.

Diagnosis

Adrenal gland disorders can often be diagnosed by blood test. These tests can identify blood levels of cortisol and other indicators such as adrenocorticotropic hormone, catecholamines, aldosterone and potassium.

If Dr. Castillo suspects that your adrenal gland disorder is the result of a tumor, he may use selective venous sampling, X-rays, CT scans or other imaging tests to look for the tumor.

Treatment

Surgical intervention may be required in the cases of hyperplasia, adenomas or malignancy. Depending upon the patient's situation, Dr. Castillo performs minimally invasive or open surgery to treat adrenal conditions. Whenever possible, he employs minimally invasive techniques in order to provide patients with the best outcome and the least amount of disruption to their lives. These procedures are done under general anesthesia in an operating room and patients recover during a few days in the hospital.

Open Adrenalectomy
Open adrenal surgery can be done through the abdomen, flank, or back and is usually preferred when there is a very large adrenal tumor.

Laparoscopic Adrenalectomy
In this minimally invasive surgery, three or four small incisions are made in the abdomen. Then a tiny camera is inserted into an opening, and instruments are used to remove the adrenal gland.