Adrenal adenoma – Non Cancerous Tumors

Adrenal adenomas are non cancerous tumors of the adrenal gland situated over the top of each kidney. They are benign and arise from the adrenal cortex which is the outer layer of the gland. This adrenal cortex generally makes hormones belonging to the steroid family.

Adrenal adenomas are termed as functioning if they produce hormones but excessive amounts of such hormones are not healthy. It is termed as non-functioning if there is no production. Often, adrenal adenomas are found by chance during body scans and the adrenal masses have to be evaluated carefully to check its hormone production. Most adrenal adenomas are discovered by chance when an abdominal computed-tomography (CT) or magnetic-resonance imaging (MRI) scan is done for unrelated symptoms.

Genetic changes may cause adrenal adenomas but its real cause is still unknown. They are commonly associated with inherited diseases like carney complex, multiple endocrine neoplasia type I and Beckwith-Wiedemann syndrome. A poorly controlled condition of congenital adrenal hyperplasia – genetic defects of body manufacturing steroid hormones – has a higher risk of adrenal adenomas. Its risk increases with age.

As the causes are undefined, even the symptoms are not definite and generally no symptoms are caused. Proper investigations may reveal that adrenal adenomas produce abnormal amounts of steroid hormones to some extent. It is mostly seen that the abnormality of excessive cortisol production is widely seen. Cortisol is a steroid hormone which is responsible for stress and energy balance. Mass production of steroid hormones causes obvious symptoms and it causes Cushing’s syndrome while excessive aldosterone causes Conn’s syndrome while large amounts of male sex steroids cause hair growth and acne. Pain in the flanks and back with bleeding adenomas are very rare.

The adrenal adenomas require specialized scans and hormone investigations and the endocrinologist are referred to who will perform examination for cancerous growths and its spread. Specialized tests to check the hormone levels are carried out. Oral contraceptive pills are advised to be avoided as the female sex hormones in the pill makes interpretation of the blood levels of steroid hormones difficult, rather, barrier methods like condoms with spermicidal creams should be used.

Tests for adrenal adenomas include 24-hour urine collection for adrenaline and non-adrenaline, blood test for potassium, male and female sex hormones, rennin and aldosterone activity, a 'low-dose dexamethasone suppression test' and additional scans like x-ray and mri scan of adrenal glands may be needed.

The treatment for adrenal adenomas is the surgical removal of the adrenal glands which is called adrenalectomy. Adrenal lumps not producing hormones are scanned yearly to check if there is any change in it. One can know details about the surgery by watching top medical videos online.

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