[Surgical management in patients with endocrine disease]

The surgical diagnosis and treatment of endocrine tumors is individually described in each session of this journal. I will described the recent topics of endocrine surgery. In thyroid, ultrasonography has developed rapidly, and increases the diagnostic ability of thyroid and parathyroid tumors enable minimally invasive thyroidectomy and parathyroidectomy. Unfortunately, recombinant human TSH and 131I high dose therapy are not widely used in Japan. In hyperparathyroidism, whole PTHH assay is currently available. Intraoperative quick whole PTH assay is essential for direct mini-incision parathyroidectomy. Although MIBI scintigraphy is useful to detect parathyroid tumors, but this use is not approved by the government. Somatoscintigraphy is promising method to detect neuroendocrine tumors. Differential diagnosis of Cushing syndrome and Preclinical Cushing syndrome have been clearly. Adrenal venous sampling by fine catheter is useful to detect micro mass of primary aldosteronism.