Adrenal tumors are common. Studies assume that around 3% of all adults have a tumor in the adrenal gland. The older you are, the more common adrenal tumors can be. Many people don’t know they have an adrenal tumor. The majority of adrenal tumors are uncritical because they are benign. However, if a tumor is more than 1 cm in diameter or if symptoms arise, for example due to hormone overproduction, those affected should speak to an endocrinologist as soon as possible.
What are adrenal tumors?
Adrenal tumors are tumors that form in the adrenal gland. The majority of adrenal tumors are benign and arise directly in the adrenal cortex. If tumors are found in the adrenal gland, two questions must be answered:
- Does the tumor produce hormones or not?
- Is the tumor benign or malignant?
If an adrenal tumor does not produce hormones, there are usually no symptoms. This is why these tumors often go unnoticed for a long period of time. Hormone-active adrenal tumors produce hormones and indicate their presence accordingly. Depending on which hormone is released excessively, the symptoms manifest themselves in different ways. See phonejust for Hypermenorrhea Meaning.
Malignant tumors are rare compared to benign tumors in the adrenal gland. Malignant tumors can be metastases, i.e. originate from tumors in another organ. They can also be tumors originating from the adrenal gland. These can then usually be assigned to the clinical picture of the carcinoma. Carcinoma is very rare.
Malignant tumors in the adrenal gland can be inherited. Benign tumors are usually an overproduction of tissue.
Symptoms, Ailments and Signs
Symptoms differ depending on the type of adrenal tumor. In the case of hormone-inactive tumors, patients are free of complaints and symptoms. Only from a certain size do the tumors trigger a feeling of fullness or nausea, for example. Hormone-active tumors, on the other hand, have different clinical pictures. Which these are is significantly influenced by whether the tumor originated from the cells of the adrenal cortex or from the adrenal medulla and which hormone is produced in excess.
Cushing’s syndrome produces too much cortisol. The consequences of this are bone pain, muscle atrophy, osteoporosis, diabetes, high blood pressure, acne, frequent infections, heavy sweating, psychoses or growth disorders. Another symptom is uncontrolled weight gain.
Patients suffer from a strong increase in the abdomen (“beer belly”), in contrast, arms and legs are very slim. A very round face, which is colloquially referred to as a moon face or full moon face, is also a typical symptom of Cushing’s syndrome. The storage of fat in the face, which is responsible for the optically round shape, also leads to a strong reddening of the facial skin.
In Conn syndrome, the hormone aldosterone is produced. This influences the water balance in the kidneys. It ensures that potassium is excreted more, reduces the amount of water excretion overall and has an increasing effect on blood pressure. Symptoms are permanently elevated blood pressure, headaches, dizziness and muscle weakness. Excessive thirst is also a symptom.
The pheochromocytoma is usually benign. The tumor causes an overproduction of adrenaline and noradrenaline. Associated symptoms are either permanent or transient high blood pressure, headache, dizziness, profuse sweating/sweating, tachycardia and cardiac arrhythmias, tremors, diabetes mellitus, weight gain, nervousness, anxiety and angina pectoris.
In particular, the combination of headaches, palpitations and sweating as well as high blood pressure that cannot be controlled with medication are strong symptoms that should result in an examination for an adrenal tumor.
Adrenal carcinoma can trigger all the symptoms associated with hormone overproduction. Patients can suffer from all of the symptoms of Cushing’s syndrome or from an excess of sex hormones. Excessive body hair or balding, a deep voice in women or breast growth in men, and a feeling of fullness and pain in the kidney area also occur.
Diseased adrenal glands result in typical physical impairments and pathological changes. As part of the functional diagnostics, the hormone level of the adrenal glands is determined. Blood is taken for this purpose. The concentration of blood salts is measured. The same is examined with a urine sample. The examinations provide information on whether hormone overproduction is taking place. Two tests can be used for precise clarification: the CRH test and the desamethasone inhibition test.
Further diagnostics are carried out with computer tomography, which detects adrenal tumors from a diameter of 5 mm. With a diameter of 2 cm, it is highly effective. Ultrasound scans detect tumors larger than 2 cm. The examination method of magnetic resonance imaging is indicated in the diagnosis of pheochromocytomas, as is scintigraphy. With a selective blood sampling from the adrenal vein, it is examined whether there is an overproduction of hormones.
When should you go to the doctor?
Adrenal tumors are usually discovered by chance, for example with ultrasound or other imaging methods. Symptoms can also point to these tumors: If headaches, palpitations and sweating as well as uncontrollable blood pressure are present over a longer period of time, those affected should first go to their general practitioner.
Other symptoms of an adrenal tumor may include: constant bloating, kidney pain, skyrocketing weight gain, tachycardia and cardiac arrhythmias, as well as headaches, nausea, dizziness, or anxiety. A general practitioner can carry out the first examinations here and, in the next step, refer the patient to an endocrinologist. The diagnosis of the type of tumor and further treatment must be carried out by a specialist.
The therapy depends on the detected tumor. The therapy concepts are often diverse and cannot be reduced to one or two therapy approaches.
- Patients with an advanced stage tumor are treated with chemotherapy or local radiation.
- In hormone excess syndrome, surgery can be done to reduce the tumor mass. On this basis, the chances for a possible subsequent chemotherapy are improved.
- Radiation of metastases is also a possible therapeutic approach.
- A number of drugs attack adrenal tumors. Endocrinological protective monitoring is scheduled as part of the therapy. The levels of ACTH, cortisol and DHEAS are checked.
- Glucocorticoid therapy against active residual tumors is also indicated.
Outlook and forecasts
If adrenal tumors are found exclusively in the kidneys, the five-year survival rate is over 70%. The smaller a tumor is, the higher the chances of recovery. The survival rate is 90% in the early stages. The further a tumor has progressed, the lower the chances of recovery and the lower the life expectancy. From stage IV (end stage) there is usually no chance of recovery. Life expectancy at this point is about a year if untreated, or two years with chemotherapy.
Follow-up care is coordinated between the family doctor/internist, clinic and endocrinologist. In a surgical procedure, the skin sutures are removed after 10 days. This is followed by appropriate follow-up therapy, such as radiation. If patients are tumor-free, regular follow-up examinations are required, which determine how to proceed individually.