The adrenal gland is a retroperitoneal organ which functions to provide hormones to the entirety of the body.
Benign Adrenal Disease
The adrenal gland can develop benign tumors which are hormone-producing and can be treated either medically or surgically.
These conditions include:
- Adrenal adenoma- a benign lesion that can often times be monitored with imaging.
- Aldosterone producing tumors (aldosteronomas) which can cause elevated blood pressure
- Hormone secreting tumors (pheochromocytoma) which can cause dangerously elevated blood pressure and must be evaluated and treated urgently.
Adrenal Cancer
Adrenal cancer is a rare cancer that is most likely to occur in children under the age of five and adults in their 40s and 50s. Adrenal cancer affects the adrenal glands which are responsible for producing hormones that provide instructions to the body’s organs and tissues.
Every year, about 200 individuals are diagnosed with adrenal cancer.
The cause of adrenal cancer is currently unknown. Adrenal tumors are formed when mutations in the DNA of an adrenal gland cell cause the cell to multiply uncontrollably and eventually break away and metastasize.
Symptoms of adrenal cancer include weight gain, muscle weakness, pink or purple stretch marks on the skin, nausea, vomiting, abdominal bloating, back pain, fever, loss of appetite and unexplained weight loss. Another symptom is hormone changes in women that can cause excess facial hair, irregular periods and hair loss on the head. For men, hormone changes that cause enlarged breast tissue and shrinking testicles may be a sign of adrenal cancer.
Risk Factors for Adrenal Cancer
Individuals with the following inherited syndromes are at increased risk for developing adrenal cancer:
- Beckwith-Wiedemann syndrome
- Carney complex
- Li-Fraumeni syndrome
- Lynch syndrome
- Multiple endocrine neoplasia, type 1 (MEN 1)
Diagnosis of Adrenal Cancer
Adrenal cancer may be diagnosed using blood and urine tests, imaging tests, and laboratory analysis of the adrenal gland.
A blood and urine sample can be used to detect unusual levels of hormones produced by the adrenal glands, such as cortisol, aldosterone and androgens.
Adrenal cancer may also be diagnosed using CT, MRI or positron emission tomography (PET) scans. These scans will help doctors see the size and location of the cancerous tumors and allow them to check if the cancer has spread to the lungs or liver.
A laboratory analysis of the adrenal gland will involve removing the affected adrenal gland so that a pathologist can determine if the patient has cancer and which cells are involved.
Adrenal Cancer Treatment
Treatment options for adrenal cancer may include surgery, medication, radiation therapy and or chemotherapy.
If a patient decides to proceed with surgery, the doctor will perform an adrenalectomy to remove the affected adrenal gland. If the cancer has metastasized or spread to other organs such as the liver or kidney, parts or all of those organs may need to be removed as well.
The drug Mitotane (Lysodre) can also be prescribed to treat advanced adrenal cancer or delay the cancer’s recurrence. Patients should consult with their doctor to find out if this treatment option is appropriate for them.
Certain patients with adrenal cancer may be good candidates for radiation therapy, a treatment that involves using X-rays and protons to kill cancer cells. Radiation therapy may be used to destroy any cells that remain after adrenal cancer surgery. This treatment option can also help reduce pain and other symptoms of adrenal cancer that has metastasized.
Chemotherapy is another effective course of treatment for patients with adrenal cancer. This drug treatment uses chemicals to destroy cancer cells and may help slow the spread of the cancer.
