Adrenal tumors can be malignant (cancer) or benign (not cancerous). Even benign adrenal tumors can be dangerous or cause uncomfortable symptoms. The adrenal glands are part of the endocrine system, which releases hormones into the blood system.
“Although the majority of these tumors are benign, around 30% of adrenal tumors greater than 4 cm are malignant - most represented by adrenal cortical carcinoma, and the survival rate for these patients is very poor unless detected early.”
Adrenal cancers (carcinomas) are very rare, and the exact number diagnosed in the United States each year is not known. It is probably around 200 per year. These cancers are much less common than benign adrenal tumors (adenomas), which are found fairly often among middle aged and elderly people.
Most tumors in the adrenal glands are not cancer. (These may be called benign tumors.) It's often hard to tell if an adrenal tumor is cancer (malignant) or benign. If the tumor grows and spreads to lymph nodes or other parts of the body, it's cancer.
While benign (non-cancerous) tumors in the adrenal gland are very common, cancers in or around this gland are very rare. They are found in only 1 or 3 per 1 million people.
Anyone can get an adrenal adenoma, although the likelihood increases with age. Approximately 3% to 9% of people have adrenal adenomas. They're the most common type of adrenal gland tumor.
Without treatment, adrenal tumors can continue to grow. As they get bigger, tumors may press against other organs. This pressure can affect how well those organs work or cause other symptoms. Functioning adrenocortical carcinomas will continue to overproduce hormones that control various body functions.
When the tumor is found at the early stage and can be removed surgically, the five-year survival rate is 50-60 percent. The prognosis for adrenal cancers that have spread to nearby or distant organs is much less favorable, with only 10-20 percent surviving five years.
Adrenocortical cancers are often aggressive and can spread to other parts of the body (metastasize) rapidly. The adrenal gland is one of the most vascular organs in the body, with many blood vessels that can carry malignant cells throughout the body.
Although the adrenal glands are essential for life, one gland can usually do the work of both. Doctors also remove the entire gland if you have a cancerous tumor called an adrenocortical carcinoma or if you have cancer that has spread to the adrenal gland from another part of the body.
The rule is to never biopsy an adrenal tumor.
The only time to consider a biopsy of an adrenal tumor is if the patient has another cancer, typically of the lung, kidney, breast, colorectal or melanoma and one is suspecting an adrenal metastasis.
The 5-year survival rate for people with adrenocortical carcinoma is 50%. However, the survival rate depends on different factors, including the extent (or stage) of cancer at the time it is diagnosed. Other factors that affect survival include the person's age and whether the tumor produces hormones.
The causes of adrenal tumors are not fully understood, although we know that some rare genetic conditions increase the risk. These include multiple endocrine neoplasia type 2, von Hippel–Lindau syndrome, familial paraganglioma syndrome, neurofibromatosis type 1, Carney complex, and Li–Fraumeni syndrome.
Chemo does not work very well for adrenal cancer, so it is most often used for adrenal cancer that has become too widespread to be removed with surgery (although it is very unlikely to cure the cancer).
CT Scans (CAT Scans) to Evaluate Adrenal Tumors and Growths. The CT scan (also called CAT scan) is very accurate at examining the adrenal glands and other abdominal structures and can be used on any type of adrenal tumor.
The results of our study show that approximately one-third of radiologically proven adrenal adenomas grow over time, and all adenomas that grew did so at a rate less than 3 mm/year, whereas all malignant adrenal nodules grew faster than 5 mm/year.
A functional adrenal tumor: a functional adrenal tumor causes an imbalance of adrenal hormones. Removal of the tumor may restore normal adrenal function. Large adrenal tumor: Other reasons to remove an adrenal gland are for adrenal tumors that are greater than 4 to 6 cm or have grown in size.
Most benign adrenal tumors cause no symptoms and don't need treatment. But sometimes these tumors secrete high levels of certain hormones that can cause complications. The most common hormones that can be over-secreted are aldosterone and cortisol from the cortex and adrenalin hormones from the medulla.
When adrenal cancer is found early, there is a chance for cure. But if the cancer has spread to areas beyond the adrenal glands, cure becomes less likely. Treatment can be used to delay progression or recurrence. Most growths that form in the adrenal glands are noncancerous (benign).
A pheochromocytoma is a tumor in the adrenal gland. It causes the gland to make too much of the hormones epinephrine and norepinephrine. This tumor often occurs when you are in your 30s, 40s, or 50s. It happens to both men and women. Experts don't know what causes these tumors.
If you have an adrenal gland tumor, your symptoms may include: High blood pressure (hypertension) Women: Excess facial and body hair, deep voice or problems with menstruation. Men: Breast tenderness or enlargement, lowered sex drive and/or erectile dysfunction.
With the availability and improvement in imaging modalities, adrenal incidentalomas are not uncommon in clinical scenario. Adrenal incidentalomas ≥4 cm in size are likely to be malignant; however, adrenal oncocytoma, a rare cause of adrenal incidentaloma, despite being larger in size, is usually benign.
Surgeons often perform a procedure called an adrenalectomy to remove a benign adrenal tumor. They can often use a minimally invasive (laparoscopic) surgery for tumors in the adrenal gland. This procedure uses small cuts (incisions) instead of the large cut that's used in open surgery.
Due to the widespread use of imaging, incidental adrenal masses are commonly encountered. A number of pitfalls can result in misdiagnosis of these lesions, including inappropriate choice of imaging technique, presence of pseudolesions, and overlap of imaging features of different adrenal lesions.
The main treatment for adrenal cancer is removal of the adrenal gland, an operation called an adrenalectomy. The surgeon will try to remove as much of the cancer as possible, including any areas of cancer spread. If nearby lymph nodes are enlarged, they also will need to be removed and checked for cancer spread.