Cleveland Clinic Florida provides state-of-the-art treatment for diseases of the thyroid, parathyroid and adrenal glands. A special emphasis is placed on coordinating care so that patients can experience a comprehensive consultation in one visit. Our endocrine surgery team has unique expertise for complex endocrine problems including patients requiring reoperative surgery or those with complex thyroid cancers and endocrine malignancies.

You may schedule an appointment online or by calling 877.463.2010.

What We Treat

What We Treat

Adrenal Cancer and Metastases

Adrenal cancer (primary adrenal carcinoma) is a rare, aggressive form of cancer in which cancer cells are found in the adrenal cortex, the outside layer of the adrenal gland. Symptoms of adrenal cancer include abdominal pain, weight loss and/or related to overproduction of hormones, such as cortisol and androgens (high blood pressure, high blood glucose and increased hair and irregular periods in women). Early diagnosis is vital because adrenal cancer may spread (metastasize) to other, distant organs.

Cleveland Clinic Florida offers the full spectrum of diagnoses and surgical treatment of adrenal cancer. Learn more about adrenal cancer and metastases, its symptoms, diagnoses and treatment.

Adrenal Incidentaloma

Adrenal incidentaloma are masses or tumors (larger than 1 cm) that are found on the adrenal gland (the gland located above each kidney). The term “incidentaloma” refers to the fact that the mass is usually found “incidentally” while the patient is being examined for another condition, such as abdominal pain or injury. At Cleveland Clinic Florida, adrenal incidentaloma is diagnosed through a CT scan or MRI, which helps guide treatment of either continued monitoring or surgery of the tumor. Surgical treatment is recommended for adrenal incidentaloma that has malignant features, a mass that is very large or is excreting excessive adrenal hormones. Learn more about adrenal incidentaloma, its symptoms, diagnoses and treatment.

Adrenal Tumors

Tumors in the adrenal glands may cause a variety of conditions, including Cushing’s syndrome, Conn’s disease (hyperaldosteronism) and pheochromocytoma. Cushing’s syndrome most frequently occurs in adults between the ages of 20 and 50, and is caused by the excess production of hydrocortisone (cortisol). Conn’s disease is an extremely rare disease that usually occurs in women due to excessive growth (hyperplasia) in tissues of both adrenal glands or a benign tumor in a single gland. In pheochromocytoma, the rare disease stems from a tumor in the adrenal medulla leading to overproduction of adrenaline and noradrenaline. Learn more about the adrenal tumor disorders including Cushing’s syndrome, primary hyperaldosteronism (Conn’s Syndrome), and pheochromocytoma, their symptoms, diagnoses and treatments.

Beta-cell Disorders - Insulinoma

Insulinoma is a tumor of the pancreas that produces excessive amounts of insulin. More than 90 percent of insulinomas are benign (non-cancerous), with these tumors occurring more commonly in women. While the tumors are usually small (less than 2 cm), insulinomas produce excessive amounts of insulin causing hypoglycemia (low blood sugar). Even though insulinoma is the most common pancreatic islet cell tumor, it is a rare condition. Except in very rare familial situations (those that occur in families, transmitted genetically from parent to child), the exact cause of insulinoma is unknown.

Symptoms of Insulinoma:

  • Anxiety
  • Behavior changes
  • Clouded vision
  • Coma
  • Confusion
  • Convulsions
  • Dizziness
  • Headache
  • Hunger
  • Loss of consciousness
  • Rapid heart rate
  • Sweating
  • Tremor
  • Weight gain

Diagnosis of Insulinoma

To properly diagnose insulinoma, the patient fasts for a period of time before completing a series of blood tests. After fasting, your blood may be tested for:

  • Blood C-peptide level
  • Blood glucose level
  • Blood insulin level
  • Drugs that cause the pancreas to release insulin

A CT or MRI scan of the abdomen, or PET scan may be completed to look for a tumor in the pancreas. If the test is negative, one of the following tests may be performed:

  • Endoscopic ultrasound
  • Octreotide scan
  • Pancreatic arteriography
  • Pancreatic venous sampling for insulin

Treatment of Insulinoma

Surgery is the recommended treatment for insulinoma, and in most cases can cure the disease. If there are many tumors, part of the pancreas will need to also be removed (partial pancreatectomy). At least 15 percent of the pancreas must be left to produce its enzymes for digestion, which may prevent a total removal of the insulinoma tumor. If there are many insulinoma or they continue to come back, in rare cases the entire pancreas is removed. Removing the entire pancreas leads to diabetes due to insulin no longer being produced. Insulin injections are then required. If surgery is not an option, patients may receive the drug diazoxide (Proglycem) to lower insulin production and prevent hypoglycemia. A diuretic (water pill) is often given to prevent fluid retention, and the medication octreotide may be used to reduce insulin release.

Cushing’s Syndrome

Cushing’s syndrome, also known as Cushing’s disease, commonly occurs when a person is exposed for a long time to high levels of certain chemicals called adrenal glucocorticoids, one of which is called cortisol. Normally the adrenal glands (located on top of each kidney) make sufficient amounts of cortisol, which provides adequate response to stress. When there is too much cortisol in the body, symptoms of Cushing’s disease can occur, including weak bones and muscles, easy bruising, weight gain and high blood pressure. Treatment of adrenal or pituitary tumors that cause Cushing’s disease includes dose adjustment of medications, surgery, radiation therapy or use of drugs that reduce the production of cortisol. Learn more about Cushings Syndrome its symptoms, diagnosis and treatments.


Goiter is an enlargement of the thyroid gland. The thyroid gland is a small, butterfly-shaped gland located in the neck, below your Adam’s apple, which is responsible for producing the hormones thyroxine (T4) and a small amount of triiodothyronine (T3). These hormones influence such bodily functions such as body temperature, mood and excitability, pulse rate, digestive functions, and other processes. Goiters have different causes depending on their type. Goiters can be classified as simple, hereditary or due to other diseases and conditions. Treatment options depend on the size of the goiter’s enlargement, symptoms and the underlying cause. Learn more about Goiters their symptoms, diagnoses and treatments.


Hypercalcemia refers to levels of calcium in your blood that are higher than normal. Calcium is important to many body processes, including bone growth, maintaining proper hormone levels, and correct functioning of nerves, muscles and the brain. Hypercalcemia is fairly rare, affecting 0.1 percent to 1 percent of the population, with postmenopausal women more likely to be diagnosed with the condition. Ninety percent of all hypercalcemia cases are caused by problems with the parathyroid glands or some cancers. There are several treatment options for hypercalcemia depending on what is causing the disorder and how severe it is. Learn more about hypercalcemia’s symptoms, diagnoses and how the condition is treated at Cleveland Clinic Florida.


Primary hyperparathyroidism is a hormonal problem due to one or more parathyroid glands producing too much parathyroid hormone. Parathyroid glands, four small glands located in the neck near the thyroid gland, keep blood calcium from falling below normal. In rare cases, there may be more than four of these glands, and they may be in other parts of the neck or in the chest. In 80 to 85 percent of patients with primary hyperparathyroidism, a single gland is affected. In 15 to 20 percent of patients, two or more glands are affected. The affected gland(s) enlarge and produce too much parathyroid hormone. As a result, blood calcium becomes high, bones may lose calcium, and kidneys may excrete too much calcium. At present, the only known cure for primary hyperparathyroidism is surgical removal of the affected gland(s). Learn more about primary hyperparathyroidism, its symptoms, diagnosis and treatment.


Hyperthyroidism is an over activity of the thyroid, which causes your thyroid to produce and release more hormones than your body needs. This can affect your body and the way it functions. There are several types of hyperthyroidism, including Graves’ disease, thyroid nodules and thyroiditis. Both men and women can have hyperthyroidism, but it occurs most often in women aged 20 to 40. There are many treatments for hyperthyroidism, including medications and surgery. Learn more about hyperthyroidism its symptoms, diagnoses and treatments.

Liver Metastases

Malignant (cancerous) liver tumors often occur when cancer spreads (metastasizes) from another part of the body to the liver. When cancer cells break away from the original (primary) tumor, they may be carried through the bloodstream to the liver, which filters the blood. If these cancer cells attach to the liver, they form new tumors called metastases. Liver metastases originate most commonly from colon cancer, by way of the portal vein, which carries blood from the intestines to the liver. It is much less common for liver metastases to develop from cancer in the breast, esophagus, stomach, pancreas, lungs, kidneys, and skin (melanoma). Learn more about metastatic cancer and liver tumors, their symptoms, diagnoses and treatment.


Multiple endocrine neoplasia (MEN) type I is a disease passed down through families in which one or more of the endocrine glands are overactive or form a tumor. Endocrine glands most commonly involved include the pancreas, parathyroid and pituitary glands. The condition may occur at any age, affecting both men and women equally. As with MEN I, multiple endocrine neoplasia type II (MEN II) is an inherited disorder in which the endocrine glands are overactive or form a tumor, affecting the adrenal, parathyroid and thyroid glands. A tumor in the adrenal gland is called a pheochromocytoma. A medullary carcinoma refers to a tumor in the thyroid gland. Most pituitary and parathyroid tumors are noncancerous (benign), but some pancreatic tumors may become cancerous (malignant) and spread to the liver. Surgical removal of MEN I / II tumors is usually recommended. Learn more about MEN I / II, its symptoms, diagnosis and treatment.

Menopause & Menopausal Transition (Perimenopause)

Menopause is defined as the cessation of menstrual cycles, which usually occurs at about age 50 in most women. For two to eight years prior to this, menstrual cycles may be irregular. This is referred to as the menopausal transition or perimenopause. As estrogen and progesterone levels decline women may experience a variety of symptoms, including hot flashes, sleep disturbances, fatigue, irritability, decreased sex drive, vaginal dryness and depression. Long-term estrogen deficiency can also result in osteoporosis (thinning of the bones). Learn more about the symptoms, diagnoses and treatment of menopause and perimenopause.


Obesity is a chronic condition defined by an excess amount of body fat. Body mass index (BMI) is a term routinely used by physicians and researchers to describe and calculate a person's body weight, taking into account one's height to determine a person's obesity or general overweight/underweight condition. The BMI equals a person’s weight in kilograms divided by height in meters squared (BMI = kg/m2). For adults, a BMI of 30 or more is considered a state of obesity and a BMI greater than 40 is considered to be a state of severe obesity. Approximately one in three Americans is obese and the incidence of obesity has doubled since 1991. Obesity increases the risk of developing a number of chronic disease including: adult onset diabetes, high blood pressure, high cholesterol, heart attacks, stoke, chronic liver disease, congestive heart failure, cancer, gallstones, gout, osteoarthritis, sleep apnea and Pickwickian syndrome.

Learn more about obesity and the specialized procedures and treatments offered for the condition.

Carotid Paraganglioma

Carotid paraganglioma (also called a carotid body tumor or chemodectoma) is a tumor found in the upper neck at the branching of the carotid artery. Two carotid arteries (one on each side of the neck) supply blood to the large, front part of the brain, where thinking, speech, personality and sensory and motor functions reside. Although carotid paragangliomas are not normally deadly, they can be locally aggressive, causing pain, hoarseness, difficulty swallowing, Horner syndrome, or shoulder drop. Due to its side effects, it is often recommended that the tumor be surgically removed, accompanied by radiation therapy. Learn more about carotid paraganglioma, its symptoms, diagnosis and treatments.

Parathyroid Cancer

Parathyroid cancer is a rare disease in which malignant (cancer) cells form in the tissues of a parathyroid gland. The parathyroid glands are four pea-sized organs found in the neck near the thyroid gland, which make parathyroid hormone (PTH or parathormone). PTH helps the body use and store calcium to keep the calcium in the blood at normal levels. A parathyroid gland may become overactive and make too much PTH, a condition called hyperparathyroidism. Sometimes hyperparathyroidism can be caused by parathyroid cancer, but this is very rare. The extra PTH causes a condition called hypercalcemia (too much calcium in the blood). The hypercalcemia caused by hyperparathyroidism is more serious and life threatening than parathyroid cancer itself and treating hypercalcemia is as important as treating the cancer. Learn more about parathyroid cancer, its symptoms, diagnosis and treatments.


Pheochromocytomas are tumors that develop in the adrenal medulla, the inner portion of the adrenal gland, which can cause overproduction of catecholamines. Catecholamines are hormones such as epinephrine and norepinephrine that are involved in maintaining blood pressure. Excess of catecholamines causes high blood pressure in most of the cases. Pheochromocytoma is a rare disease with most cases presenting as a single, benign tumor; of all patients with hypertension (high blood pressure), less than one percent has adrenal tumors and the resulting hormone overproduction. However, if left untreated, it can have serious consequences, including heart attack, stroke, and other life-threatening conditions. Learn more about pheochromocytoma, its symptoms, diagnosis and treatment.

Secondary Hyperparathyroidism

Secondary hyperparathyroidism is the result of another condition that lowers calcium levels. As a result, the parathyroid glands overwork to compensate for the loss of calcium. Factors that may contribute to secondary hyperparathyroidism include severe calcium deficiency, severe vitamin D deficiency and chronic kidney failure. Secondary hyperparathyroidism is typically managed with medications, but surgery may be necessary for the best outcome. Learn more about secondary hyperparathyroidism, its symptoms, diagnosis and treatment.

Tertiary Hyperparathyroidism

Tertiary hyperparathyroidism is condition in which long standing secondary hyperparathyroidism cannot be reversed, even by adequate treatment. This condition is most commonly seen in patients with kidney failure. Tertiary hyperparathyroidism is best treated by surgical removal of the parathyroid glands. Similarly to treatment for secondary hyperparathyroidism, treatment for tertiary hyperparathyroidism involves removing most of the parathyroid glands. A small portion of parathyroid tissue is preserved to regulate calcium levels following surgery. Learn more about tertiary hyperparathyroidism, its symptoms, diagnoses and treatment.

Thyroid Cancer

The thyroid is a hormone-producing organ (or gland) that is located on the front of the neck, just below the Adam’s apple (center of the larynx). The thyroid gland produces and secretes thyroid hormones into the bloodstream, which control such functions as body temperature, digestive and heart functions, and all body processes needed for life. Sometimes thyroid tissue begins to grow uncontrollably, causing one or more nodules to form for unknown reasons. Cancer (malignancy) is the biggest concern when nodules form. Cancerous nodules can invade the tissues of the neck, spread to the surrounding lymph nodes, or to the bloodstream, and then to other parts of the body. Treatment plans of thyroid cancer are based on the stage and the type of cancer. Learn more about the types of thyroid cancer, their symptoms, diagnoses and treatment.

Thyroid Nodules

A thyroid nodule is an abnormal growth (lump) of thyroid cells within the thyroid gland. The thyroid is a hormone-producing, butterfly-shaped organ (or gland) that is located on the front of the neck, just under the Adam's apple (the larynx). The thyroid gland, which is made up of a right lobe and a left lobe, produces and secretes thyroid hormones into the bloodstream. Thyroid hormones govern functions such as body temperature, digestive and heart functions, and all body processes needed for life. Sometimes thyroid tissue begins to grow, causing one or more nodules to form for unknown reasons. Cancer (malignancy) is the biggest concern when nodules form. Thyroid nodules are very common, but fortunately, about 95 percent of these are benign (non-cancerous). Learn more about thyroid nodules, its symptoms, diagnoses and treatment.

Hiatal Hernia

Hiatal hernia is a condition in which part of the stomach sticks upward into the chest, through an opening in the diaphragm. There are two main types of hiatal hernias, a sliding hiatal hernia and a paraesophageal hernia. In most patients, the cause of a hiatal hernia is not known, although the condition occurs more often in people over the age of 50, in overweight people (especially women) and in smokers. Hiatal hernias can be diagnosed with a barium study or with esophagoscopy.

At Cleveland Clinic Florida, we offer the full spectrum of treatment for hiatal hernias, including a laparoscopic surgical approach, which is less invasive and offers a faster recovery than traditional hiatal hernia surgery. Learn more about hiatal hernia, its symptoms, diagnoses and treatment.



Raul Rosenthal, MD
Raul Rosenthal, MD
Department Chair
Appointments & Locations

Appointments & Locations

To schedule a consultation, please call toll-free 877.463.2010. You can also make an appointment online.

Virtual Visits

You can now stay connected to your healthcare team through virtual visits, using your smartphone, tablet or computer.

Why go virtual? It's an easy, convenient and secure way to see your provider face-to-face without having to leave home. This saves you travel time, parking fees and time spent in the waiting room — and you can also have a loved one or caregiver join you. If appropriate, you can also get a prescription sent to the pharmacy of your choice.

Many insurance companies cover the cost of virtual visits, so check with your insurance company ahead of time. Interested in getting started? Call your provider to find out what virtual visit options are available.


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