Benign Adrenal Tumors

Adrenal tumors are growths in the adrenal glands, which are small organs located above each kidney. These glands are part of the body's hormone-making system, and they release chemicals (hormones) that tell different parts of the body what to do. Your organs and tissues depend on these hormones to function properly.

The adrenal glands have two main parts: the cortex and the medulla. Tumors that develop in the cortex are called adrenal adenomas. Tumors in the medulla are called pheochromocytomas.

Most of these non-cancerous (benign) tumors don't cause any noticeable problems and don't need treatment. But sometimes, these tumors produce too much of certain hormones. This overproduction can lead to health issues.

Hormones from the cortex control many important processes, including how your body uses energy (metabolism), blood pressure, and even things like hair growth. Hormones from the medulla are involved in your body's response to stressful situations. If a tumor produces too much of these hormones, it can disrupt these processes, causing various symptoms.

Benign tumors of the adrenal glands can cause various symptoms, depending on several factors. These factors include whether the tumor produces hormones, which hormones are produced, and how much of each hormone is made. Importantly, many benign adrenal tumors don't produce any hormones and therefore don't cause any noticeable symptoms.

The most common type of benign adrenal tumor is called an adenoma. These tumors develop in the outer layer of the adrenal gland, called the adrenal cortex. When an adenoma does produce hormones, it can lead to a range of symptoms. These might include:

• Weight gain: This can happen if the tumor affects hormones related to metabolism.
• Easy bruising: Hormonal changes can make blood vessels more fragile.
• High blood pressure (hypertension): Some hormones can cause blood vessels to narrow, raising blood pressure.
• Diabetes: Tumors affecting hormone production can disrupt the body's ability to regulate blood sugar levels.
• Changes in mood, like feeling depressed: Hormonal imbalances can impact mood.
• Tiredness and fatigue: This can be a result of hormonal disruptions and/or other complications.
• Muscle weakness or cramping: Again, hormonal imbalances can impact muscle function.

Another type of benign adrenal tumor, called a pheochromocytoma, develops in the inner part of the adrenal gland, called the adrenal medulla. Pheochromocytomas are more likely to produce symptoms, which often include:

• High blood pressure (hypertension): This is a common symptom due to the hormones released by the tumor.
• Fast heartbeat (tachycardia): The hormones released by these tumors can speed up the heart rate.
• Excessive sweating: This is another possible side effect of the hormones released by the tumor.
• Tremors: These shaking sensations can be caused by the hormonal imbalance.
• Headaches: These can be a result of the changes in blood pressure or other hormone-related factors.

It's crucial to remember that not everyone with an adrenal tumor will experience symptoms. If you have concerns about adrenal gland problems, it's important to talk to your doctor.

Sometimes, doctors don't know why a person develops a non-cancerous tumor in their adrenal glands.

Some things can increase your chances of getting a non-cancerous tumor on your adrenal gland. These include:

• Family history: If someone in your family has had a non-cancerous adrenal tumor, you might have a higher risk. This means that a close relative, like a parent, sibling, or grandparent, had this type of tumor.

• Inherited conditions: Some inherited conditions, called genetic syndromes, can make you more likely to develop a non-cancerous adrenal tumor. These are conditions that run in families and can affect multiple parts of the body. Examples include conditions that increase your risk for certain cancers or other medical issues. Having a genetic syndrome doesn't guarantee you'll get a tumor, but it does increase your chances.

• Previous surgery: If you've had a non-cancerous adrenal tumor removed in the past, you may have a higher risk of getting another one. This is because sometimes a previous tumor can be a sign of a larger problem that increases the risk of new tumors forming.

Sometimes, doctors find small growths in the adrenal glands during medical tests for other reasons. These growths, called adrenal tumors, are usually harmless, but the doctor needs to check if they might be cancerous or if they're producing too much of a hormone.

To figure this out, doctors first do a physical exam. Then, they order blood and urine tests to see if the tumor is making too much of a particular hormone. These tests also help identify which hormone is being overproduced.

Further tests, called imaging tests, can give doctors more details about the tumor. These tests help determine the tumor's potential for being cancerous (which is rare). The imaging tests can also help pinpoint the tumor's exact size and location.

Different types of imaging tests may be used:

• CT scan: A CT scan uses X-rays to create detailed cross-sectional images of the body. Think of it like taking many X-rays from different angles and putting them together to create a 3D picture. This helps doctors see the tumor's shape and size.

• MRI scan: An MRI scan uses a powerful magnet and radio waves to create detailed images of the inside of the body. This gives a very detailed view of the tumor and surrounding tissues.

• MIBG (Meta-iodobenzylguanidine) scan: This scan uses a special radioactive substance injected into the body. Some adrenal tumors absorb this substance more than normal. The scan shows where the substance is concentrated, helping pinpoint the location and size of the tumor.

• PET (Positron Emission Tomography) scan: A PET scan also uses radioactive substances, but in a different way. It detects the radioactive material taken up by the tumor. This helps doctors see if the tumor is active and potentially cancerous.

• Ga-DOTATATE PET scan: This is a newer type of PET scan that's particularly good at finding tumors in the endocrine system, including adrenal tumors. It's often combined with a CT or MRI scan for a more complete picture. It isn't used as frequently as other scans.

These tests help doctors determine the best course of treatment for the adrenal tumor. Importantly, many adrenal tumors are benign (not cancerous).