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The adrenal glands, located right above the kidneys, produce hormones that are critical to your health and well-being. Everyone is familiar with adrenaline, and it is one of the main hormones that the adrenal gland produces.
The adrenal glands respond to signals from the nervous system and secrete hormones—including cortisol, metanephrines, and aldosterone—that regulate stress, help maintain metabolism, and distinguish male and female physical and sexual characteristics.
Adrenal surgery often is necessary when you’re either producing too many or not enough adrenal hormones. This can be because of a growth on the adrenal gland. Read on to learn about adrenal gland tumors so you can spot the signs and seek the treatment you need.
LISTEN: Dr. Felger discusses adrenal surgery in the Medical Intel podcast.
Diagnosing Adrenal Tumors
Most growths on the adrenal glands are not cancerous but may produce hormones that can influence the patient’s blood pressure or response to stress.
An adrenal tumor is considered a functional tumor if it’s producing too many hormones. You may be experiencing:
If the adrenal tumor is not producing hormone, you likely won’t have any symptoms at all. Functional tumors are very treatable. Adrenal tumors that are cancerous are rare and usually grow from a cancer that started in a different organ.
There are several methods used to diagnose your adrenal tumor, including:
- Blood and urine tests: Show levels of hormones that may signal the presence of a functional adrenal tumor.
- Imaging: A CT scan or MRI scan can show whether a tumor exists and determine location and size.
- Metaiodobenzylguanidine scan: This is administered over two days. On the first day, a patient gets an injection of a radioisotope that attaches to tumor cells and a scan is taken. We repeat the scan the following day.
- Gallium Dotatate Scan: This scan is done in one visit and involves a newer radioisotope to identify some adrenal tumors.
- Adrenal vein sampling: This helps determine which of the adrenal glands is overproducing hormones.
After the diagnosis, you’ll have a consultation with your surgeon and complete necessary steps prior to surgery, which usually include labs, electrocardiogram (ECG or EKG), physical, extra imaging, and any clearances that need to be made by other physicians.
Treating Adrenal Tumors
Treatment is based on where the adrenal tumor is located, its size, and whether it is functional or not. Some patients will be treated with open surgery, which is traditionally used for larger adrenal tumors or tumors that are attached to other nearby organs.
We also offer two minimally invasive procedures: laparoscopic and retroperitoneal approaches. Laparoscopic adrenal surgery is done from the patient’s belly side, and it includes using a camera, small instruments, and small incisions to remove the adrenal gland and the tumor. Retroperitoneal adrenal surgery also uses a camera, small instruments, and small incisions, but we perform this procedure from the patient’s back.
Recovery is very straightforward for adrenal procedures that are done laparoscopically or retroperitoneally. You’ll be able to eat, walk, and take part in most regular activities shortly after surgery except for heavy lifting.
Depending on the type of adrenal tumor you have, you may need to follow up with your endocrinologist to adjust medications. You also may need further imaging studies and potentially treatment if cancer is involved.
Our adrenal patients benefit from the team approach we use at MedStar Washington Hospital Center. They can see our endocrinologists and have their nuclear medicine studies done, then follow up with the surgical team. We have a high volume of adrenal surgeries with many successful outcomes.
An Adrenal Surgery Success Story
I treated one young man who had excessively high blood pressure and was taking multiple medications. His symptoms were affecting his daily life. His doctor did a full workup and found an adrenal tumor on one side. The patient’s doctor referred him to me.
After I examined this young man, we had a good discussion about the operation to remove the adrenal tumor. I explained to him that it would hopefully help his high blood pressure, but it might not completely cure it.
He had the operation and did very well during the surgery and afterward. At his post-operative visit, he was off all his blood pressure medications. He was thrilled to be back to the usual activities that he’d been unable to take part in prior to surgery.
The adrenal gland is critical to your body’s normal function. Through our team-based approach to identification and treatment, we can help more patients overcome these tumors and get back to their healthy lives.