adrenal cancer

What is adrenal cancer?
About the adrenal glands

The adrenal glands are small glands that sit atop each kidney. Kidneys are located inside of the upper abdomen.



The adrenal gland has two parts. The outer part, called the cortex, where the majority of tumors develop. The cortex function is to make certain hormones for the body. These hormones all have a similar chemical structure and are called steroids. They include:

Cortisol causes changes in metabolism that help the body deal with stress.
Aldosterone helps the kidneys regulate the amount of salt in the blood and helps regulate blood pressure.
Adrenal androgens are hormones that can become the most common forms of the sex hormones estrogen and testosterone in other body parts. The amount of these hormones resulting from conversion of adrenal androgens is small compared to what is done in other body parts. The testes produce most of androgens (male hormones) in men. The ovaries produce most of the estrogens (female hormones) in women.
The inner part of the adrenal gland, called the core, is really an extension of the nervous system. Hormones nervous system such as norepinephrine and epinephrine (also called adrenaline) are made in the bone. Tumors and cancers arising in the adrenal medulla include pheochromocytomas (which are often benigna) and neuroblastomas.

This paper discusses tumors and cancers of the adrenal cortex. Not discussed the tumors of the adrenal medulla. Neuroblastomas are covered in a separate document.

Tumors of the adrenal cortex

There are 2 main types of tumors of the adrenal cortex: benign (non-cancerous) and malignant (cancers). Most of these tumors are benign and are called adenomas. Cancers of the adrenal cortex are rare. These 2 types of tumors can sometimes be difficult to distinguish when the cells were observed under a microscope. Although experienced pathologists (doctors who are trained to diagnose diseases by examining tissue under a microscope) can tell the difference in most cases, sometimes the only way to know with certainty that the tumor is a cancer is when it spreads. If it spreads to the lymph nodes or other organs and tissues, it is a cancer. Adenomas do not extend outside the adrenal gland.

Adrenocortical adenomas

Most tumors of the adrenal cortex are not cancer. They are benign tumors called adenomas. These tumors are small, usually less than 2 inches (5 centimeters) in diameter. They usually occur in one adrenal gland, but sometimes affect both.

Most people with adrenal adenomas have no symptoms and are not aware they have an adrenal tumor. Some of these adenomas are discovered by accident (of course) when CT or MRI of the abdomen are made due to a related health problem. About 5% of people who have an abdominal CT was found to have an adrenal tumor was not suspected. Many of these are functional, which means that produce adrenal hormones. Sometimes these tumors are known by the nickname incidentalomas because they are not causing problems and only found by accident.

Some adenomas produce too much adrenal steroid hormones. Sometimes, too much of the hormone can cause symptoms. Many symptoms related hormones adenomas are the same as those of adrenal carcinomas (cancers). These symptoms are discussed in the section, "The signs and symptoms of adrenal cancer." Adenomas are more likely than carcinomas produce high levels of aldosterone can cause high blood pressure.

Treatment: adenomas can be cured by removing the adrenal gland containing the adenoma. Some adrenal adenomas causing hormone-related symptoms can be effectively treated with medicines that block the production or action of these hormones. This may be the best treatment option for patients with other serious medical problems that may not be able to withstand a major operation.

Incidentalomas treatment depends on the possibility that there may be a cancer and whether or not it raise levels of hormones. Accidentally when an adrenal tumor is found, tests are often done to see if hormones are doing. If so, surgery often is recommended. Otherwise, surgery may be recommended only if it is likely to be a cancer. Small tumors are less likely to be cancer, and are often monitored but not treated. CT (or MRI) may be repeated in 6-24 months to see if the tumor has grown. If so, you may need to be removed. If you have not grown, hormone levels were observed in the coming years. If the tumor is still small and does not make any hormones, you may not need to be treated at all.

The remainder of this document refers only to adrenal cancers and adenomas not.

Cancer of the adrenal cortex

The type of cancer that develops in the cortex of the adrenal gland is called adrenocortical carcinoma. Also it is known as adrenocortical cancer (or carcinoma) or simply adrenal cancer. In this document, the term adrenal cancer is used to mean cancer that begins in the adrenal cortex.

Adrenal cancer most often is discovered when:

It is by accident on an imaging test done for something more.
It produces hormones that cause changes such as weight gain and fluid retention, precocious puberty in children, or excess facial or body hair growth in women.
Begins causing symptoms because it has gotten too big. Large tumors can put pressure on other organs in the abdomen, causing pain or a feeling of fullness. In general, adrenal cancers are much larger than adrenal adenomas. Adrenal tumor greater than 5 or 6 centimeters (about 2 to 2 1/2 inches) is assumed to be a cancer. In one study, the average size of an adrenal cancer was about 13 cm (or 5 inches).
Most cancers found in the adrenal gland and not start there are no adrenal cancers. Instead, they start in other organs or tissues, then (metastasis) spread through the bloodstream to the adrenal glands. For example, lung cancers, melanomas and breast cancers often spread to the adrenal glands. Even when other cancers spread to the adrenal glands; However, still they named after the place started and are treated as other cancers that begin in the same place. They are not considered adrenal cancer. Treatment described in our documents about these cancers.