Adrenal Tumors

Cancerous adrenal tumors are abnormal growths occurring in the adrenal glands -- two small glands just above the kidneys.

The adrenal glands are responsible for making the hormones that control your heart rate and blood pressure. They also help balance water and salt in the body, and control the use of protein, fat and carbohydrates.

Adrenal tumors can be benign or malignant (cancer). Benign tumors are called adenomas, and can either be “functional,” meaning that they secrete abnormal amounts of hormones, or “nonfunctional,” which do not secrete abnormal amounts of hormones. Benign adrenal tumors may require surgical removal depending on their size, appearance or whether they are functional.


Symptoms of Adrenal Tumors

Many adrenocortical tumors are called “functional” and cause the body to make more hormones than normal. This includes cortisol, aldosterone, testosterone and estrogen. As many as half of patients who develop malignant adrenal tumors will have symptoms of increased metabolic activity. Symptoms vary according to which hormone is overproduced.

Too much cortisol may cause:

  • Weight gain in the face, neck and trunk.
  • Growth of fine hair on the face, upper back, or arms.
  • Deepening of the voice and swelling of the sex organs or breasts (both men and women).
  • Muscle weakness, high blood sugar and high blood pressure.

Too much aldosterone may cause:

  • Muscle weakness or cramps.
  • Frequent urination.
  • Feeling thirsty.

Too much testosterone (in women) may cause:

  • Growth of fine hair on the face, upper back or arms.
  • Acne.
  • Balding.
  • A deepening of the voice.
  • No menstrual periods.

Men who make too much testosterone do not usually have signs or symptoms.

Too much estrogen (in women) may cause:

  • Irregular menstrual periods in premenopausal women.
  • Vaginal bleeding in women who have gone through menopause.
  • Weight gain.

Too much estrogen (in men) may cause:

  • Growth of breast tissue.
  • Lower sex drive.
  • Impotence.

Patients may also feel pain in their abdomen or back, or a feeling of abdominal fullness.

HVIadrenal.jpg


Types of Adrenal Cancer

Adrenal cancer is a rare type of cancer that affects only about 200 people per year in the United States. This cancer forms in the tissues of the adrenal glands -- two glands just above the kidneys. The adrenal glands are responsible for making the hormones that control your heart rate and blood pressure. They also help to balance water and salt in the body, and control the use of protein, fat and carbohydrates.

There are two types of adrenal cancer:

  • Malignant pheochromocytoma, which starts in the center of the adrenal gland.
  • Adrenocortical carcinoma, which starts in the adrenal gland’s outside layer.

Treatments for Adrenal Cancer

How adrenal cancer is treated depends on the stage of the cancer. When the adrenal cancer is localized, surgery to remove the adrenal gland is the usual treatment. If the cancer has metastasized, chemotherapy is also used. Because this is such a rare disease, much of the treatment is through clinical trials.


Risk Factors for Adrenal Cancer

Certain genetic conditions increase the risk of adrenocortical carcinoma, including Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome and Carney complex.


How Adrenal Cancer is Diagnosed

Adrenocortical carcinoma can be diagnosed using imaging and blood and urine tests. A 24-hour urine test can measure the amounts of cortisol (an adrenal hormone) or 17-ketosteroids (adrenal cortical hormones).

Dexamethasone suppression tests can also check for the presence of too much cortisol. A blood chemistry study can also be used to measure the amounts of potassium or sodium in the blood. Imaging studies might include a CT scan, MRI of the abdomen, adrenal angiography or adrenal venography, PET (positron emission tomography) or MIBG (metaiodobenzylguanidine, using nuclear medicine technology) scans.



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