Surgery for adrenal tumors

The body has two adrenal glands; one rests atop each kidney. The outside layer of your adrenal glands (called the cortex) makes three main hormones:

• Cortisol, which regulates your response to stress
• Aldosterone, which helps control your blood pressure
• Androgens and estrogens, which control your reproductive organs

The inner part of the adrenal gland, the adrenal medulla, produces your adrenaline hormones.

Tumors that develop in the adrenal glands may be a cancer (malignant) or benign. Benign tumors are either functioning or nonfunctioning, meaning they either make hormones or do not. One’s symptoms often depend on which hormones an adrenal tumor makes.

Cortisol-secreting tumors – Patients with adrenal tumors that secrete cortisol often have Cushing's syndrome. Patients with Cushing's syndrome frequently present with weight gain, easy bruising, high blood pressure, diabetes, weakness, mood changes and changes in their appearance such as "moon face" (a rounded shape of the face), a ruddy or reddening of the complexion, or "buffalo hump” (a mound of fat at the base of the back of the neck). Some patients are noted to have an elevated cortisol level without symptoms of Cushing's syndrome, which is called subclinical Cushing's syndrome.

Aldosterone-secreting tumors – Patients with an aldosterone-producing adrenal tumor usually have high blood pressure. These tumors are called aldosteronomas.

Pheochromocytoma –  A pheochromocytoma is a tumor of the adrenal medulla that produces catecholamines (too much adrenaline). Historically patients with pheochromocytomas would have symptoms of headaches, sweating and heart palpitations, but in modern times many patients are totally asymptomatic.

Adrenocortical cancer is uncommon. The majority of individuals diagnosed are between 50 and 60 years old. People are often diagnosed at a later stage, because signs and symptoms may not be obvious, if they occur at all. Although treatable, adrenocortical cancer has a high recurrence rate.

Often adrenal tumors are found on a CT or MRI scan done for something different. These tumors are often called adrenal “incidentalomas.” Most adrenal incidentalomas are benign, but they must be evaluated by an experienced physician to see if they are secreting hormones or potentially a cancer.