The adrenal glands are triangle shaped structures on top of each kidney and release hormones into the blood.
The adrenal gland is composed of a medulla in the center of the gland which produces catecholamines (the stress hormones epinephrine and norepinephrine). The outer portion, or cortex, of the adrenal makes other hormones involved in normal physiology and metabolic function.
Growths on the adrenal glands can be benign or cancerous and the development of most adrenal tumors is felt to be sporadic and not related to particular genetic or environmental risk factors. Even benign adrenal masses may be functional and produce excessive hormones, and therefore require definitive treatment.
Certain genetic syndromes, however, are associated with higher risk of adrenal tumors including Li-Fraumeni syndrome, multiple endocrine neoplasia type2 and neurofibromatosis type 1.
It is very common to find adrenal masses ‘incidentally’ on a CT scan or MRI done for unrelated symptoms. Depending on your overall medical condition and the size and appearance of the mass, your doctor may recommend additional imaging and blood tests to evaluate for functionality, as even benign adrenal tumors can be associated with symptoms. Additional workup may include a biopsy of the mass and/or continued regular surveillance imaging. Masses which are functional and over 5 cm, will most commonly be treated with surgical removal.
Adrenocortical cancer
The vast majority of benign adrenal tumors are Adenomas. In some cases these will produce significant symptoms and are associated with syndromes. Overproduction of cortisol hormone can occur for a variety of reasons but, in patients with Cushing’s syndrome, the adrenal gland has an adenoma which accounts for this excess production. Aldosterone is another hormone produced in the cortex of the adrenal gland and, similarly, overproduction can be caused by a benign adenoma.
