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Adrenal adenomas are noncancerous tumors of the adrenal gland that can secrete hormones causing various medical problems. They tend to have a genetic basis and are usually discovered through imaging scans. Surgical removal is the treatment for functional adenomas.
An adrenal adenoma is a benign or noncancerous tumor of the adrenal gland, located just above the kidney. Some of these adenomas, called nonfunctioning adrenal adenomas, don’t secrete hormones, but others do. Depending on the type of hormone secreted by the adenoma, the tumor can cause different medical problems in the patient.
Adrenal adenomas tend to have a genetic basis and usually only appear in adults. The risk of developing one increases with age, and about 6% of patients over 60 have an adrenal adenoma. There is currently no known prevention for these growths. Most are discovered through computed tomography (CT) or magnetic resonance imaging (MRI) of the abdomen for unrelated reasons.
If an adrenal adenoma releases cortisol, the patient may develop Cushing’s syndrome, also known as hypercorticism or hyperadrenocorticism. Cushing’s syndrome is characterized by an excess of cortisol in the blood and symptoms include excessive sweating, rapid weight gain, thinning of the skin and mucous membranes, and facial hair growth. Patients with Cushing’s syndrome typically gain weight in the torso and face but not in the limbs, and they develop pads of fat along the back of the neck and collarbone, a symptom called a buffalo hump. Cushing’s syndrome can also cause various skin disorders, heart disease, diabetes mellitus, high blood pressure, gastrointestinal disorders, impaired wound healing, and osteoporosis. Psychological problems including insomnia, loss of libido, depression, anxiety and psychosis can also result.
If an adrenal adenoma releases aldosterone, the patient may have Conn’s syndrome or primary aldosteronism. Conn’s syndrome causes sodium retention and hypocalcemia, or low calcium levels. Symptoms can include high blood pressure, muscle cramps and weakness, and headaches. Finally, an adrenal adenoma can secrete androgens, leading to hyperandrogenism. Hyperandrogenism can cause excessive body hair growth, loss of hair growth on the scalp, deeper voice, acne, obesity, infertility, and increased muscle mass. In women, it can also cause the uterus or breasts to shrink.
If an adrenal adenoma is functional or releasing hormones of any kind, the resulting symptoms may be treated through surgical removal of the adenoma or adrenalectomy. Usually, the adenoma is small enough to be removed via laparoscopy, in which the tumor is extracted through very small incisions. XNUMX% of adrenal adenomas fail to function and cause no harm to the patient.
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