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. These tumors can give off too much cortisol or other hormones.
“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.
An adrenal nodule is when normal tissue grows into a lump. Most incidental adrenal nodules do not cause health problems. However, they need to be evaluated for signs of excess hormone production or suspicion of malignancy.
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.
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.
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.
As a general rule of thumb, adrenal tumors greater than 4 cm should be considered for removal (3 cm for younger people). The skilled interpretation of your blood work and X-ray studies is where an experienced adrenal gland surgeon is extremely important in guiding whether adrenal gland removal is necessary.
A nodule can disrupt adrenal gland function and trigger a wide variety of symptoms, such as unexplained changes in body weight, high blood pressure, headaches, muscle spasms, decreased sex drive and fatigue. In some cases, however, a nodule may not cause any noticeable symptoms.
Tumors that are generally larger than three centimeters (1.2 inches) are called masses. If your tumor is three centimeters or less in diameter, it's commonly called a nodule. If the nodule forms in your lungs, it's called a pulmonary nodule. Hamartomas are the most common type of benign lung nodule.
Most growths that form in the adrenal glands are noncancerous (benign). Benign adrenal tumors, such as adenoma or pheochromocytoma, also can develop in the adrenal glands.
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.
Most adrenal gland tumors are benign, or noncancerous, but need to be treated if symptoms appear. There are several types of adrenal tumors that may require treatment.
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.
Results: The records of 117 patients who underwent evaluation for tumors of the adrenal gland were reviewed. The median tumor size of the adrenal cortical carcinomas (n = 38 carcinomas) was 9.2 cm (range, 1.7-30 cm); 5 cancers (13.5%) were smaller than 5.0 cm.
Laparoscopic Adrenalectomy
A telescope and small instruments are inserted into the abdomen through these small incisions, which allow the surgeon to completely remove the diseased adrenal gland. The adrenal gland is placed in a plastic sack and removed intact through one of the incisions.
Can an adrenal adenoma become cancerous? Adrenal adenomas can become cancerous, but this is rare. The most common cancerous tumor that forms in your adrenal glands is adrenocortical carcinoma. Like adrenal adenomas, functioning adrenocortical carcinoma tumors secrete excess hormones.
Nodules from one to four centimeters are likely to be benign, but your doctor will probably recommend blood tests to check for excessive hormone production. Nodules larger than four centimeters are more likely to produce excessive hormones or be cancerous.
Adrenalectomy has the same risks as other major surgeries — bleeding, infection and a bad reaction to the anesthesia. Other possible risks include: Injury to organs close to the adrenal gland. Blood clots.
Local anesthesia is medicine to numb the biopsy area. You may still feel pressure or pushing during procedure, but you should not feel any pain.
Adrenal tumors are usually removed with a minimally invasive surgery called a laparoscopic adrenalectomy. When you remove an adrenal tumor, you remove the associated adrenal gland with it. Your body can easily adapt to having only one adrenal gland secreting the hormones necessary for your daily living.
Your doctor will thoroughly examine your abdomen for evidence of a tumor (or mass). Your blood and urine will likely be tested to look for high levels of the hormones made by some adrenal tumors. If an adrenal tumor is suspected, imaging tests will be done to look for it. These tests can also help see if it has spread.
ANSWER: Adrenal adenomas are one of several types of nodules that develop on the adrenal glands. They are common, and they usually don't pose a health threat or require treatment.
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.