Uncover the specifics of adrenal adenomas, from their often accidental discovery to the factors that may lead to treatment.

Your body is a complex network of systems working together, one of which includes the adrenal glands. These small but mighty glands regulate a variety of vital functions, producing hormones that impact total body function.

The word adenoma refers to an outgrowth of cells, or a tumor for short, from a site of glandular tissue in your body. The discovery of an adenoma anywhere in your body doesn’t imply that it’s inherently dangerous or malignant.

If you’ve been recently diagnosed with an adrenal adenoma, it may seem overwhelming and scary at first. However, a deeper understanding of this relatively simple condition reveals that it’s commonly harmless and easily managed.

An adrenal adenoma is a benign tumor that can form in your adrenal glands. Located right above your kidneys, the adrenal glands play a crucial role in your body. They produce a variety of hormones that control various vital functions such as metabolism and blood pressure.

Although adrenal adenoma is a type of tumor, most don’t have any associated symptoms. In fact, they’re most often accidentally discovered during an imaging study such as a CT scan. However, they can sometimes be associated with specific symptoms.

Adrenal adenomas are classified as either functioning or non-functioning. The difference is that functioning adenomas produce excessive hormones and result in symptoms, while non-functioning adenomas do not.

Functional adrenal adenomas can result in symptoms of another disorder called Cushing syndrome. The symptoms of Cushing syndrome are all related to excessive cortisol and may include the following:

The presence of an adrenal adenoma can be definitively diagnosed either by a CT scan or MRI. Additionally, these imaging studies can also determine whether the tumor is a benign adenoma (noncancerous) or a malignant adrenal carcinoma (cancerous).

Prior to imaging studies, a provider might begin with a few basic physical exams, such as blood pressure and a skin exam, depending on your symptoms. Blood and urine tests for hormones such as cortisol and aldosterone may also be ordered, which help determine whether the adenoma is functioning.

What specialty manages adrenal adenoma?

An endocrinologist typically manages adrenal adenomas. Endocrinologists specialize in the treatment and detection of hormone and glandular disorders. These medical professionals have extensive training in diagnosing and treating diseases that involve the adrenal glands.

Depending on your case, you may also be referred to an endocrine surgeon, especially if the adenoma needs to be surgically removed. These surgeons are experienced in performing operations on the endocrine glands, including the adrenal glands.

Research from 2018 highlighted the rarity of adrenal carcinoma, stating that only about 14% of all discovered adrenal masses are cancerous. There’s limited evidence to suggest that benign adrenal adenomas can become cancerous, although it’s believed to occur in an extremely small percentage of people.

If an adrenal tumor is cancerous, it’s likely that it will be discovered that way rather than become cancerous, especially if it’s large. Tumors larger than 4 cm typically have a higher risk of being cancerous, according to a 2020 study.

The exact cause of adrenal adenomas remains unknown. However, certain risk factors have been associated with their development.

The American Cancer Society lists several genetic syndromes that are thought to contribute to the development of adrenal cancer:

Additional, broad factors mentioned also include:

  • being overweight
  • smoking
  • having a sedentary lifestyle

Note that these risk factors are not specific to adrenal adenomas and are generally thought to increase your likelihood of all types of cancer, according to the Centers for Disease Control and Prevention (CDC).

Treatment for an adrenal adenoma depends on whether or not the adenoma is functioning or non-functioning. Non-functioning adenomas without symptoms often don’t require treatment. However, regular monitoring to ensure they don’t grow or start producing hormones is typically recommended.

On the other hand, functioning adenomas require treatment to manage hormone levels and corresponding symptoms. Treatment can involve medications to control hormone production, and in some cases, surgery may be necessary.

When do adrenal adenomas need to be removed?

According to 2017 research, there are several reasons an adrenal adenoma would need to be removed:

  • the tumor’s size is greater than 4 centimeters (cm)
  • the tumor’s size is rapidly increasing
  • the tumor is secreting hormones (functioning)
  • there is a high risk that the tumor will become malignant

Removing an adrenal tumor requires a surgery called an adrenalectomy. In most cases, a minimally-invasive technique called laparoscopic surgery is performed. Following surgery, the outlook for complete recovery is extremely high.

Although the word tumor may evoke fear, the reality of adrenal adenomas is not as terrifying as it might seem. Often asymptomatic and accidentally discovered, these benign growths only sometimes lead to symptoms.

Rest assured that the overwhelming majority of adrenal adenomas are noncancerous. Remember, while the presence of an adrenal adenoma can seem alarming and may require surgery, it’s a condition that can be safely and effectively managed by healthcare professionals.