Types of adrenal gland tumors
A tumor begins when normal cells change and grow uncontrollably, forming a mass. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can spread to other parts of the body. A benign tumor means the tumor will not spread.
A tumor can start in an adrenal gland, called a primary adrenal tumor, or it can begin in another organ, such as the lungs, and then spread to the adrenal glands. An adrenal gland tumor can sometimes overproduce hormones. When it does, the tumor is called a functioning tumor. An adrenal gland tumor that does not produce hormones is called a nonfunctioning tumor. The symptoms and treatment of an adrenal gland tumor depend on whether the tumor is functioning or nonfunctioning, what hormone(s) is overproduced, and whether the tumor is a primary adrenal gland tumor or if the cancer has spread from another organ.
Also called an adrenocortical adenoma, this is the most common type of adrenal gland tumor. It is a noncancerous, nonfunctioning tumor of the adrenal cortex. An adenoma usually does not cause symptoms and, if it is small, often does not need treatment.
Although rare, adrenocortical carcinoma is the most common type of cancerous adrenal gland tumor. It is also known as adrenal cortical carcinoma. Approximately four to 12 out of one million people develop this type of tumor, which begins in the adrenal cortex. Adrenocortical carcinoma can be a functioning or nonfunctioning tumor. If the tumor is functioning, it may produce more than one hormone.
This is a type of childhood cancer that can begin in the adrenal medulla.
This type of neuroendocrine tumor most often begins in the adrenal medulla. Learn more about pheochromocytoma.
Symptoms and Signs
People with an adrenal gland tumor may experience the following symptoms or signs. Sometimes, people with an adrenal gland tumor do not show any of these symptoms. Or, these symptoms may be caused by a medical condition that is not a tumor.
- High blood pressure
- Low potassium level
- Heart palpitations
- Feelings of anxiety or panic attacks
- Excessive perspiration
- Abdominal pain
- Unexplained weight gain or weight loss
- Abdominal stretch marks
- Excessive hair growth
- Unusual acne
- Change in libido (sex drive)
In addition, pheochromocytoma may cause dangerous surges of the adrenal gland hormones that regulate blood pressure and response to stress. A hormonal surge can cause blood pressure to increase very quickly, increasing the risk of heart attack, stroke, hemorrhage, or sudden death.
If you are concerned about one or more of the symptoms or signs on this list, please talk with your doctor. Your doctor will ask how long and how often you’ve been experiencing the symptom(s), in addition to other questions. This is to help find out the cause of the problem, called a diagnosis.
If a tumor is diagnosed, relieving symptoms remains an important part of medical care and treatment. This may also be called symptom management, palliative care, or supportive care. Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.
Doctors use many tests to diagnose a tumor, find out if it is cancerous, and if so, whether it has spread to another part of the body, called metastasis. Some tests may also determine which treatments may be the most effective. To diagnose an adrenal gland tumor, blood and urine tests (see below) are done to look for certain substances that help determine if the tumor is functional or non-functional. A computed tomography (CT or CAT) scan or a magnetic resonance imaging (MRI) scan (see below) may also be useful in making a diagnosis and evaluating whether an adrenal gland tumor may be cancerous. Imaging tests may also be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:
- Age and medical condition
- Type of tumor suspected
- Severity of symptoms
- Previous test results
In addition to a physical examination, the following tests may be used to diagnose an adrenal gland tumor:
Blood and urine tests. Blood tests can measure the amounts of natural hormones, such as catecholamines and metanephrines, produced during stress, which can detect a functional tumor. A patient may be asked to take a pill on the evening before the blood and urine tests to help detect the normal suppression of production of the hormone cortisol. A 24-hour urine sample, which requires the collection of all urine during that timeframe for laboratory testing, may also be needed. This helps the doctor track how quickly various hormones are produced. Tell your doctor about any medications that you take, even over-the-counter drugs, because this information is needed to correctly interpret the results.
Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. For an adrenal tumor, a narrow, hollow needle is used to collect the tissue. This is called a fine needle biopsy or fine needle aspiration. The biopsy is performed by a radiologist who uses specialized imaging procedures, such as CT or MRI scans (see below) to direct the needle into the tumor. The sample removed during the biopsy is analyzed by a pathologist. A pathologist is a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.
If the doctor suspects that cancer has spread to the adrenal gland from another area of the body where the cancer started, a biopsy may be done to determine the type of cancer, which can help the doctor plan treatment.
CT scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a special dye called a contrast medium is given before the scan to provide better detail on the image. This dye can be injected into a patient’s vein.
MRI. An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. MRI can also be used to measure the tumor’s size. A special dye called a contrast medium is given before the scan to create a clearer picture. This dye can be injected into a patient’s vein.
Metaiodobenzylguanidine (MIBG) scan. MIBG is a chemical similar to adrenaline that will collect in a neuroendocrine tumor. A MIBG scan can show a tumor of the adrenal medulla that may not appear on an x-ray. The scan takes place over two consecutive days. On the first day, an injection of MIBG is given in the arm. Several hours later, pictures are taken with a special camera that can detect if or where in the body the MIBG has collected. The following morning, more pictures are taken, and the process may be repeated if needed.
After diagnostic tests are done, your doctor will review all of the results with you. If the diagnosis is a tumor, these results also help the doctor describe it; this is called staging.
For an adrenal gland tumor, different types of doctors often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team.
Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Your care plan may also include treatment for symptoms and side effects, an important part of cancer care. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Also, talk about the goals of each treatment with your doctor and what you can expect while receiving the treatment. Learn more about making treatment decisions.
Up to 25% of adrenal tumors may be linked to a genetic syndrome. When planning treatment, it may be helpful to talk with a genetic counselor to learn whether the tumor is associated with a specific syndrome. In addition, your family may learn whether other family members should undergo specific genetic tests. Learn more about genetic testing.
Source and Detailed Information: go to Cancer.net