Adrenal
What is the adrenal gland?
You have two adrenal glands. They rest in the back of your abdomen just above your kidneys. The adrenal glands are responsible for producing several hormones that help regulate many things in your body. 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 you blood pressure
- androgens and estrogens – which control your reproductive organs
The inside of your adrenal glands (called the medulla) makes catecholamines (epinephrine, norepinephrine and dopamine). These hormones are frequently referred to as "adrenaline" and mediate your "flight or fight" response. Tumors of the adrenal gland frequently produce one of the above hormones.
My doctor told me I need to have one adrenal gland removed. Can I survive with only one adrenal gland?
Yes. Only one (and sometimes even a portion of one) adrenal gland is necessary to function normally.
What is a pheochromocytoma?
A pheochromocytoma is a tumor of the adrenal gland that produces catecholamines (too much adrenaline). Historically, patients with pheochromocytomas would have symptoms of headaches, sweating and heart palpitations, but in modern times, these tumors are frequently found incidentally on a CT scan done for something else. Many times, patients are totally asymptomatic.
What is an adrenal incidentaloma?
An adrenal incidentaloma is an adrenal tumor that is found during a CT, MRI or ultrasound being done for an unrelated reason. Adrenal incidentalomas occur in about 1-7% of patients and are more common as we get older. Most adrenal incidentalomas are benign, but they must be evaluated by an experienced physician to see if they are secreting hormones or could potentially be a cancer.
What is Cushing's syndrome?
Cushing's syndrome means you have too much of the hormone cortisol in your blood. Cortisol is important in your response to stress and plays a role in regulating your blood sugar, immune response, mood, and weight. 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 a "moon face" or "buffalo hump." There are many causes of Cushing's syndrome, but sometimes it is caused by a tumor in the adrenal gland. Some patients are noted to have an elevated cortisol level without symptoms of Cushing's syndrome. We call this subclinical Cushing's syndrome.
What is an aldosteronoma?
Aldosterone is a hormone produced by your adrenal glands that helps regulate your blood pressure. Small tumors of the adrenal gland can produce too much of this hormone leading to high blood pressure. These tumors are called aldosteronomas.
What is adrenal cancer? My doctor told me I have an adrenal tumor. Does this mean I have a cancer?
Adrenal cortical cancers are fairly uncommon. About 10% of incidentally discovered adrenal tumors are adrenal cancer. Most incidentally discovered adrenal tumors are not cancer, but they may still produce hormones that affect your blood pressure, mood, weight, etc. Typically, tumors that produce hormones should be removed, even though they are not cancer. In addition to tumors coming from the adrenal glands themselves, other cancers can spread to the adrenal glands. We call these metastases. It is unusual for an adrenal tumor to be the first finding of a cancer from some other location.
How are adrenal tumors removed?
Adrenal tumors are usually removed with a minimally invasive surgery called a laparoscopic or robotic adrenalectomy. These techniques use small incisions and a camera to remove the adrenal gland, allowing for faster recovery and less pain than traditional “open” surgery through a large incision. 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.
Next Steps
Our team at UC Davis Endocrine Surgery is here to help if you are dealing with an adrenal issue. Please call 916-734-5959 to set up an appointment with one of our adrenal specialists.