A pheochromocytoma is an adrenaline-producing tumor that originates from cells in the adrenal gland (most commonly) or rarely in tissue outside of the adrenal gland. Symptoms include high blood pressure, headache, flushing, and palpitations. Treatment involves preparation with appropriate blood pressure medications followed by surgery (usually laparoscopic adrenalectomy).
Some adrenal nodules over-produce hormones such as cortisol (a steroid). Too much cortisol production is called Cushing’s syndrome, which often causes weight gain especially in the face and abdomen (belly), reddish-purple streaks on the skin, and increased blood pressure and/or blood glucose levels (early or full-blown diabetes). Other causes of high steroid levels need to be ruled out, such as taking steroid medication for arthritis. Most patients with an adrenal source of Cushing’s syndrome are cured with surgery.
Aldosterone is a mineralocorticoid, which is a type of steroid hormone that is produced by the adrenal glands that helps to control blood pressure. Primary hyperaldosteronism occurs when a nodule in the adrenal gland produces too much aldosterone. This causes high blood pressure that is difficult to control despite multiple medications, as well as low blood levels of potassium.
An adrenal incidentaloma is an asymptomatic adrenal nodule that was discovered on imaging (for example CT scan or MRI) that was ordered for an unrelated reason. Most incidental adrenal nodules do not cause health problems. However, they need to be evaluated for signs of excess hormone production or suspicion of malignancy.
Adrencortical carcinoma is a very rare cancer of the adrenal glands that occurs in about 1 per 1 million people. There are no obvious symptoms or signs unless the adrenal cancer is producing excessive hormones (such as cortisol and aldosterone). This makes it hard to detect at an early stage, and unfortunately these cancers tend to be aggressive and grow quickly.
There are some cancers that arise from other parts of the body that can spread (or metastasize) to the adrenal gland. These include breast cancer, lung cancer, and melanoma. Most patients who have metastatic cancer are recommended to undergo systemic treatment with chemotherapy. However if the only site of spread is to the adrenal gland, surgical removal with laparoscopic adrenalectomy can improve the patient’s prognosis.
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