Adrenal Tumors
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What are Adrenal Tumors?
Adrenal tumors are growths that develop in the adrenal glands, which are small, triangular-shaped glands located on top of each kidney. These glands play a crucial role in producing hormones that help regulate various bodily functions, including metabolism, blood pressure, and response to stress.
Adrenal tumors can be categorized as either benign (non-cancerous) or malignant (cancerous). While most adrenal tumors are benign and do not cause symptoms, some may overproduce hormones, leading to conditions such as Cushing's syndrome or pheochromocytoma. Malignant adrenal tumors are rare but can be more concerning, potentially spreading to other parts of the body.
Who develops Adrenal Tumors?
Although anyone could develop an adrenal tumor, they are much more common in older patients. About 10% of people older than 70 years of age have an adrenal tumor. These are most often benign and do not cause any harm or symptoms.
Do Adrenal Tumors need to be treated?
Most adrenal tumors do not require treatment if they are not causing any symptoms or concern for malignancy. They do need to be evaluated with specific laboratory tests and imaging to check for over-production of hormones or concerning signs for malignancy. Surgery is usually the main treatment for adrenal tumors that cause symptoms due to over-production of hormones or may be cancerous. If surgery is not needed, in some cases repeat imaging is performed after 6-12 months to make sure the adrenal tumor is not growing.
Adrenal Tumor Symptoms
Most adrenal tumors are not functional, which means they do not over-produce hormones and do not cause symptoms. However, some adrenal tumors do produce excess hormones which can cause the following:
1. Pheochromocytoma
Production of too much adrenaline (a hormone in your body that controls your flight or fight response).
- High blood pressure, often episodic and can lead to a hypertensive crisis
- Rapid heartbeat (palpitations), also often occurring during episodes
- Excessive sweating
- Headaches, especially during episodes of high blood pressure
- Anxiety or panic attacks
- Tremors or shaking
- Learn about Pheochromocytomas
2. Hyperaldosteronism
Production of too much aldosterone (a hormone in your body that regulates your blood pressure and potassium level).
- High blood pressure, often very severe and requiring multiple medications
- Low potassium level
- Muscle weakness
- Muscle cramps, may be caused by low potassium
- Fatigue
- Thirst and dehydration
- Learn about Hyperaldosteronism
3. Cushing ’s Syndrome
Production of too much cortisol (a hormone in your body that plays a crucial role in managing stress and regulating various functions).
- Weight gain, particularly in the upper body and face
- Purple stretch marks on the skin
- Increased fat deposits around the neck, creating a "buffalo hump"
- Easy bruising and thinning of the skin
- Slow healing of wounds
- Fatigue and weakness
- Mood changes, such as irritability or depression
- Irregular menstrual cycles
- High blood pressure
- High blood sugar
- Bone loss and osteoporosis, increasing the risk of fractures
- Learn about Cushing's syndrome
How are Adrenal Tumors Evaluated?
Adrenal tumors need to be evaluated with a combination of laboratory testing and imaging. The specific laboratory testing depends on a patient ’s medical history and symptoms. Certain medications may interfere with test results. This initial evaluation should ideally be done by an endocrinologist or endocrine surgeon, who can help to interpret test results and determine if additional testing or treatment are needed.
Specific laboratory testing may include:
Pheochromocytoma:
Blood or 24-hr urine testing for Metanephrines and Normetanephrines, which are metabolites of adrenaline.
Hyperaldosteronism:
Blood levels of aldosterone and renin.
Cushing’s Syndrome:
There are various ways to check cortisol levels. These include dexamethasone suppression test, 24-hr urine testing, and saliva testing.
Dehydroepiandrosterone Sulfate (DHEA-S):
Levels that are too low or too high may indicate a cortisol producing tumor or malignancy.
Adrenal tumors should not be biopsied (except for very rare cases). Unlike in most other areas of the body, a biopsy of an adrenal tumor cannot diagnose cancer. It can also be dangerous in cases of pheochromocytoma or adrenal cancer, where putting a needle into the tumor can cause release of hormones and very high blood pressure or spread of cancer.
Find your care
We deliver effective, minimally invasive treatments in a caring environment.
Call 310-267-7838 to connect with an expert in endocrine surgery.