The adrenal glands are two small glands located on top of the kidneys behind the abdomen. The adrenal glands produce hormones that are involved in regulating the body's metabolism, blood pressure and its response to stress. Without the adrenal glands the body could not survive without a replacement for the hormones it produces. Tumors of the adrenal gland can be functional and produce hormones, or nonfunctional and not produce hormones. Whether or not an adrenal tumor is functional will determine if it needs to be removed surgically. Most adrenal tumors are benign and nonfunctional, and if small do not require surgery. Functional adrenal tumors, large tumors or tumors with a risk of cancer should be removed surgically.
Adrenal tumors can be classified according to the type of hormone produced and the risk of malignancy.
Pheochromocytomas are tumors that arise in the adrenal gland and produce epinephrine (adrenaline) and/or norepinephrine (noradrenaline). Symptoms of these tumors include increased heart rate, palpitations, increased blood pressure, headaches, nausea and abdominal pain.
Adrenal tumors that produce a hormone called aldosterone can cause high blood pressure that can be difficult to control even with blood pressure medications. After a thorough work-up to confirm the diagnosis, surgical removal of these tumors can help to control blood pressure.
Adrenal tumors that produce the steroid hormone cortisol can lead to Cushing's syndrome. Symptoms include obesity, high blood pressure, edema, muscle weakness, thin skin, easy bruising and increased blood sugar.
Adrenal tumors that do not produce hormone are called nonfunctional adrenal adenomas. Many of these types of tumors are found incidentally on computed tomography (CAT) scan or MRIs that are obtained for another medical condition. If these tumors are small and not indicative of cancer, they can be followed with CAT scans and do not necessarily need to be removed.
Adrenocortical cancer is a rare but malignant form of cancer that begins in the adrenal gland. Some of these tumors will produce cortisol steroid hormone and patients will develop Cushing's syndrome. Surgical treatment can provide cure for tumors that are found early, and chemotherapy and radiation are used to treat more advanced cancer.
Adrenal tumors can vary in their presentation, symptoms and treatment options from patient to patient. A multidisciplinary tumor program can provide a seamless approach to the treatment of these tumors and provide exceptional care for every patient's needs.