Adrenal Tumors

Adrenal tumors are tumors on the adrenal glands. The adrenal glands are located above the kidneys and have two parts, the adrenal cortex and the adrenal medulla. The adrenal cortex secretes hormones including cortisol and aldosterone. The adrenal medulla produces dopamine, epinephrine and norepinephrine. There are different types of adrenal tumors, and they can be either cancerous or noncancerous (benign).

The vast majority of adrenal tumors are benign. Most often, they do not cause any symptoms and are discovered as incidental findings on either a CT or MRI done for completely unrelated reasons, such as for evaluation of abdominal pain. As such, they are referred to as adrenal incidentalomas. Aside from categorizing them as noncancerous (benign) or cancerous (malignant), they are categorized as functioning or non-functioning. Functioning tumors lead to overproduction of one or more of the normal adrenal hormones.

Are there any risk factors for the development of an adrenal tumor?

The cause of most adrenal tumors is unknown. Some hereditary conditions have been linked to an increased risk of developing an adrenal tumor. The hereditary conditions include:

1. Carney complex
2. Li-Fraumeni syndrome
3. Multiple endocrine neoplasia type 2
4. Neurofibromatosis type 1

Several signs and symptoms may be seen, including:

    Bruising, High blood pressure, Weakness, High blood sugar levels or diabetes, Low potassium levels, Excessive hair growth, Sweating, Increased weight or weight loss, Stretch marks on the abdomen, Depressed mood, Nervousness, Anxiety/panic attacks, Osteoporosis, Fat deposits on the neck, Heart palpitations.

The tumor may be removed via surgery. It is recommended that most functioning tumors, regardless of their size, be removed. Small, non-functioning tumors can be followed with repeat CT scans and if they remain stable in size they can be observed without treatment. If a non-functioning tumor grows more rapidly than expected, or if it approaches 5 centimetres in maximum dimension, it is generally removed. If the tumor is small and appears to be noncancerous (benign), a laparoscopic strategy (surgery without large incisions) may be ordered. For a larger tumor or one that may be cancerous, surgery with an incision in the back may be preferred. In some cases, the entire adrenal gland may need to be removed. Hormone therapy may be required prior to or after other options, such as surgery, have been done. If the tumor is cancerous, chemotherapy and radiation therapy may be needed.

Adrenal tumors can cause several problems. These problems can include:

    Cushing’s Syndrome: This condition occurs when the tumor leads to excessive secretion of cortisol. While most cases of Cushing’s Syndrome are caused by tumors in the pituitary gland in the brain, some happen because of adrenal tumors. Symptoms of this disorder include diabetes, high blood pressure, obesity and sexual dysfunction.

    Conn’s Disease: This condition involves excessive secretion of aldosterone. Symptoms include personality changes, excessive urination, high blood pressure, constipation and weakness.

    Pheochromocytoma: This condition causes excessive secretion of adrenaline and noradrenaline. Symptoms include sweating, high blood pressure, headache, anxiety, weakness and weight loss.

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Regards,

Stella

Editorial Team

Journal of Orthopedic Oncology