adrenal mass

Overview

An adrenal mass is a mass located within or arising from the adrenal gland. Although the adrenal gland is located just above the kidneys, these glands have a different set of important functions in the body. The primary function of the adrenal glands is the secretion of hormones and adrenaline. Tumors in these glands can be benign, “functional”, or malignant.

The vast majority of adrenal masses are non-functioning benign adenomas. They may be referred to as “incidentalomas”. They do not produce any hormones, are not cancers, and are found “incidentally” on a CT or MRI. Typically, these are simply observed over time as they do not require removal.

Rarely, we find “functioning” adrenal masses which produce excess levels of certain hormones. These are rare and most often produce cortisol or Aldosterone. Cortisol-producing tumors can cause symptoms such as:

• Weight gain, usually greatest above the collar bone, in the cheek area (moon face), and around the abdomen
• Fat deposits behind the neck and shoulders (fatty hump or buffalo hump)
• Purple stretch marks on the abdomen
• Excessive hair growth on the face, chest, and back in women
• Menstrual irregularities

Aldosterone producing tumors cause symptoms such as:

• High blood pressure
• Weakness
• Muscle cramps
• Low blood potassium levels

Adrenal cancers are rare. There are probably 200 diagnosed a year in the United States. They are often associated with inherited syndromes which are very uncommon.

Treatment

Treatment for adrenal masses is considered in two situations. One situation is if the tumor is a functional adrenal mass. Surgery or medical management is done to prevent the problems related to excess hormone secretion. The other reason for treatment is if the mass is large enough or has findings on CT or MRI concerning for cancer. Small, non-functioning benign masses are simply observed and require no treatment.

Treatments for adrenal cancer include medical intervention, typically by an endocrinologist, for patients that cannot tolerate surgery. Otherwise, the treatment is surgical removal. This can often be done robotically/laparoscopic.   The body needs only one adrenal gland to function normally, so the physician can remove the affected gland entirely. If the surgery is being done for cancer, surrounding organs may also need to be removed.

Radiation therapy and chemotherapy may play a role in treating adrenal cancers and would be included typically at the discretion of an oncologist.

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