The kidneys, responsible for cleaning and purifying the blood, are located inside the upper part of the abdomen. Sitting above each of the kidneys, you will find the adrenals, small glands made up of two parts:
- Cortex: The outer part of the gland, which produces important hormones for the body.
- Medulla: The inner part of the gland, which is an extension of the nervous system.
The adrenal cortex is where tumors and cancers can develop; however, they are rare, and most are benign (non-cancerous). Two main types of adrenal cortex tumors exist:
- Adenomas: Most tumors of the adrenal cortex are benign adenomas. These are small tumors, usually less than 5 centimeters (about 2 inches) in diameter. They usually occur in only one adrenal gland, but sometimes affect both glands.
- Carcinoma: The type of cancer that develops in the cortex of the adrenal gland is called adrenal cortical carcinoma. Generally, adrenal cortical cancers are much larger than adrenal adenomas. An adrenal tumor larger than 5 or 6 centimeters (about 2-2.5 inches) is usually malignant or cancerous. In one study, the average size was about 4-5 inches.
Most people with adrenal adenomas have no symptoms. Some of these adenomas are found when CT or MRI scans of the abdomen are ordered because of unrelated health problems. Many are nonfunctional adenomas; the cells are not producing enough steroid hormones to cause any symptoms.
Adrenal cortical cancers usually are discovered because the patient has a variety of symptoms, including
Weight gain and fluid retention
Excess facial or body hair growth in women
Early puberty in children
These symptoms are caused by excessive amounts of hormones produced by the tumor.
Other symptoms may include:
A feeling of fullness
These symptoms may occur because the tumor has grown and causes symptoms by pressing on other organs in the area.
Our team of experts provides comprehensive care in the treatment of adrenal tumor and cancer care. Benign adenomas can be surgically treated both laparoscopically and through open surgery.
A technique called laparoscopic adrenalectomy allows the surgeon to remove the adrenal gland with an adenoma through an instrument called a laparoscope. The laparoscope is a thin tube with a tiny video camera on the end. Once inserted through a small surgical opening in the patient's side, it allows the doctors to see where the tumor is growing. Other instruments inserted through this tube or through other very small incisions are used to remove the adrenal gland.
In some cases, adrenal adenomas that cause hormone-related symptoms can be treated with medications that stop the production or actions of these hormones. There are also small adenomas, discovered while looking for something else, that are not causing any symptoms. These do not need any treatment.
Treating Adrenal Cortical Cancers
In most cases, your doctor will recommend surgery to remove the tumor as well as the adrenal gland. Your doctor may choose a laparoscopic approach for surgery. This approach usually speeds healing and recovery after the surgery. Chemotherapy may be recommended to halt the growth of cancer throughout the body.