Adrenal Tumors
What are Adrenal Tumors?
Adrenal tumors are abnormal growths on the adrenal glands, triangular pieces of tissue that are located at the top of each kidney.
The adrenal glands consist of two different parts, each of which produce and regulate different kinds of hormones. The inner medulla makes catecholamines such as adrenaline and aldosterone, which are commonly known as “stress hormones.” The outer cortex produces hormones that regulate blood pressure and metabolism.
Adrenal tumors may be malignant (cancerous) or benign (non-cancerous), as well as functioning (hormone-producing) or non-functioning.
Malignant
- Adrenocortical cancer develops when malignant tumors form in the cortex.
- Malignant adrenal pheochromocytoma develops when malignant tumors form in the medulla.
- Malignant paragangliomas develop when tumors form in the nerve tissue or blood vessels in or near the adrenal glands.
- Adrenal cancers are very rare, with less than a thousand cases diagnosed per year in the United States.
- In early stages, adrenal cancer survival rate is 50-60%. In advanced stages, when cancer has spread to other areas of the body, survival rate is 10-20%.
Benign
- Most adrenal tumors are adenomas, non-cancerous growths.
- Pheochromocytomas and paragangliomas may also be benign (non-cancerous), though they may cause discomfort and secondary complications:
- Cushing’s Syndrome, in which a tumor may cause the adrenal glands to produce an excess of cortisol.
- Hyperaldosteronism, in which a tumor may cause the adrenal glands to make too much aldosterone.
Adrenal Tumor Symptoms
Symptoms of adrenal tumors often vary depending on the size and type of tumor. Some cases may be asymptomatic.
Symptoms of adrenal tumors may include:
- High blood pressure (hypertension)
- Excess fat tissue in the upper back, face, or neck
- Breast tenderness or enlargement
- Excessive or reduced hair growth
- Weight gain or loss
- Menstrual disturbances
- Erectile dysfunction
- Skin changes such as stretch marks or bruises
- Fatigue
- Muscle weakness or spasms
- Diabetes
- Sleep disturbances
- Potassium deficiency
- Headache
- Irregular heartbeat
- Depression, anxiety, or nervousness
- Paleness
- Dizziness
- Tremor
- Sweating
- Temporary or occasional paralysis
Adrenal Tumor Causes
Though there is no known cause for adrenal tumors, evidence suggests a link between adrenal tumors and certain inherited conditions, including:
- Li-Fraumeni syndrome, a genetic condition that increases the likelihood of developing cancer.
- Multiple Endocrine Neoplasia type 2 (MEN2), a disorder of the endocrine system.
- Von Hippel-Lindau disease (VHL), an inherited mutation of a protein called the von Hippel Lindau gene.
- Neurofibromatosis type 1 (von Recklinghausen’s disease), a disorder that causes tumors to develop in the nervous system.
- Paraganglioma syndrome, a condition in which tumors develop in paraganglia, cell bundles in the nervous system.
- Beckwith-Wiedemann syndrome, a growth disorder.
- Carney complex, a genetic condition that produces tumors in the endocrine glands.
Adrenal Tumor Diagnosis
Adrenal tumors may be difficult to diagnose due to their many types and causes.
The physician will begin with a physical examination and a medical history assessment. Next, the physician will order tests to confirm the presence of one or more adrenal tumors.
- Blood or urine tests, to determine hormone or chemical levels affected by the function of the adrenal glands.
- Imaging tests, such as CT, MRI, PET, or MIBG scans.
- Genetic tests, to determine the likelihood of inheriting a condition that may cause adrenal tumors.
Physicians have found no evidence of lifestyle changes that affect the development of adrenal tumors.
Adrenal Tumor Treatment
Treatment options vary according to the type and size of tumor but most often include:
- Surgery, to remove one or both adrenal glands.
- Systemic therapies, including radiation and chemotherapy.
- Hormone therapy, via medication, to increase or reduce hormone levels.