HIGHER-LEVEL SERVICES/DIAGNOSTICS/TREATMENTS
The UCSF Endocrine Neoplasia Destination Center offers access to multidisciplinary thought leaders and world experts in endocrine surgery and endocrine neoplasia, who have extensive, high-volume experience in all aspects of patient care. Adult and pediatric patients gain access to collaborative multi-disciplinary team care guided by monthly expert tumor boards for adrenal, thyroid, parathyroid, and pancreatic neuroendocrine diseases.
HIGH LEVEL SURGICAL INTERVENTIONS
- Same day thyroid and parathyroid surgery
- Minimally invasive parathyroidectomy
- Intraoperative PTH monitoring
- Minimal access thyroid surgery
- Cranial nerve and recurrent laryngeal nerve neuromonitoring during surgery
- Continuous vagal stimulation during surgery for voice monitoring
- Comprehensive surgical treatment for locoregional metastatic disease of thyroid cancer
- Minimally invasive adrenalectomy with 23hour admit or ambulatory, if possible
- Posterior retro-peritoneal adrenalectomy (PRA)
- Laparoscopic adrenalectomy
- Open adrenalectomy for cancer
- Minimally invasive (laparoscopic and robotic) pancreatic surgery
- Spleen & vessel preserving minimally invasive pancreatic resection
- Minimally invasive laparoscopic and robotic) hepatic surgery
- Re-operative surgery for failed or recurrent endocrine disease
- Endocrine surgery for children of any age in our comprehensive pediatric endocrine neoplasia multidisciplinary center
ENDOCRINE NEOPLASIA SPECIFIC IMAGING
Parathyroid disease
- Sestamibi/ SPECT for parathyroid disease
- 4D CT for parathyroid disease
- 18-F Fluorocholine PET/MRI scan for parathyroid disease
Adrenal disease
- DOTATATE-CT PET for pheochromocytoma and paraganglioma
- PET scan
- EUS
Pancreatic disease
- 4D CT for Pancreatic pathology
- DOTATE-CT PET for Pancreatic Neuroendocrine Tumors
IMAGE-GUIDED TESTING AND INTERVENTIONS
Thyroid disease
- FNA with molecular testing
- I 123 scanning
- Dosimetry for RAI
- RFA and ethanol ablation of metastatic cervical LNs and some selected thyroid nodules
Adrenal disease
- Selective adrenal vein sampling
Parathyroid disease
- Selective venous sampling for parathyroid disease with rapid PTH monitoring
Pituitary disease
- IPSS
- Dynamic contrast enhanced imaging of the pituitary
Pancreatic disease
- Endoscopic Ultrasound (EUS) for tumor localization & biopsy
SPECIAL TESTING
Thyroid disease
- UCSF 500: genomic profiling
Adrenal disease
- Low-dose ACTH stimulation test
- Traditional ACTH stimulation test
- Confirmatory testing for primary hyperaldosteronism:
- Oral salt load testing
- Saline infusion
- UCSF 500: genomic profiling
Parathyroid disease
- Calcium challenge testing
Pancreatic disease
- Pancreatic neuroendocrine tumor functional testing
Other endocrine disease
- Glucagon stimulation test for growth hormone deficiency
- Formal water deprivation test.
- Inpatient 72 hour fasting glucose monitoring
- Infusion centers
HIGH LEVEL TREATMENTS
- Comprehensive care and testing for children and adults with endocrine neoplasia genetic syndromes
- Multidisciplinary team for endocrine neoplasia with active tumor boards: endo, endo surg, rads/nuclear medicine, pathology, ENT, medical oncology, radiation oncology, pediatric
- Comprehensive Voice Restoration clinic
- Diabetes teaching center
- Genetic counseling for pediatric and adult patients
- Re-sensitization therapy for iodine refractory thyroid cancer (with oncology involvement)
- Azedra therapy for metastatic pheo/paragangliomas (Lutethera off label)
- Novel chemotherapeutic and small molecule therapies for locally advanced and metastatic endocrine cancers based on personalized testing, including neoadjuvant treatments
OTHER
- Access to enrollment in registries to provide patient-facing information about thyroid cancer, including patient reported outcomes