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Endocrinology Adrenalectomy General Surgery

Adrenal tumors can form as either malignant (cancerous) or benign (noncancerous). The endocrine system, which releases hormones into the circulatory system, includes the adrenal glands. These hormones play a crucial role in a variety of bodily functions such as stress management, puberty and sexual development, and metabolism.

Adrenal tumors can develop at any age. However, children under the age of 5 and people in their 40s and 50s are more likely to be affected.

Types of Malignant Adrenal Tumors

  • Adrenocortical cancer: These are tumors that originate in the cortex of the adrenal gland. There are two types of adrenocortical tumors:
    • Functioning tumors: These are the most common, and they produce hormones like cortisol, androgens, or aldosterone
    • Non-functional tumors: This type does not produce hormones
  • Malignant adrenal pheochromocytoma’s: This is a rare type of cancer that begins in the medulla.
  • Malignant paragangliomas: These tumors can start inside the adrenal gland or outside.

Types of Benign Adrenal Tumors

  • Adenomas: This is a specific type of non-cancerous tumor
  • Benign pheochromocytomas
  • Benign paragangliomas

Adrenal Tumor Risk Factors

An individual’s risk of developing an adrenal tumor may be increased by specific hereditary disorders. These include:

  • Von Hippel-Lindau disease (VHL)
  • Neurofibromatosis type 1
  • Paraganglioma syndrome: A condition whereby the tumors develop in paraganglia structures.
  • Beckwith-Wiedemann syndrome – This is a specific overgrowth disorder.
  • Multiple Endocrine Neoplasia type 2 (MEN2)
  • Li-Fraumeni syndrome

Symptoms of Adrenal Tumors

  • High blood pressure
  • Erectile dysfunction in men
  • Excessive facial and body hair, deep voice, or problem with menstruation in women
  • Muscle weakness or spasm
  • Rapid irregular heartbeat
  • Feeling of anxiety
  • Sweating
  • Temporary/intermittent paralysis
  • Headaches
  • Diabetes
  • Fatigue
  • Thin skin that bruises easily and heals slowly
  • Round, full face (moon face)

Diagnosis of Adrenal Tumors

The diverse nature of adrenal gland tumors makes them challenging to diagnose. During the diagnosis process, the doctor will do a comprehensive evaluation of the patient’s medical history and inquire about any symptoms.

One or more of the following tests may be recommended to check if the patient has an adrenal tumor or if treatment is working.

Blood tests: This test will be used to check for levels of certain hormones such as cortisol, aldosterone, plasma, and dehydroepiandrosterone (DHEA).

Urine tests: 24-hour urine collection.

Diagnostic tests such as:

  • CT scans (computer tomography)
  • MRI (magnetic resonance imaging)
  • PET scan (positron emission tomography)
  • MIBG (meta-iodobenzylguanidine) scans

Treatment of Adrenal Tumors

If an individual is diagnosed with an adrenal gland tumor, the doctor will discuss the suitable options to treat it. Treatment will depend on a variety of factors including the type of the disease and the general health of the patient. This means that the treatment will be customized to the patient’s specific needs. Treatment options include:

  • Surgery: Surgery is often done to remove one or both adrenal glands.
  • Systemic therapies: This includes chemotherapy, molecular targeted therapies, and nuclear medicine agents.
  • Medication: Normally to balance levels of hormones or replace deficient hormones.

 

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