Adrenal Tumors
Adrenal Tumors
The University of Chicago Urologic Cancer Program
Urologists at the University of Chicago specialize in the latest open and laparoscopic surgical techniques to treat adrenal tumors. In combination with colleagues in Medical Oncology and the Cancer Research Center, we offer a comprehensive and diverse option of therapies.
An Overview of Adrenal Tumors
Most people are born with two adrenal glands. They are located in the back of the abdomen, just above the kidneys. The adrenal glands produce steroid and other hormones that humans use for regular bodily functions. These hormones help regulate blood pressure, kidney function, stress responses, and some sexual functions.
Adrenal cancer is extremely rare. Many are discovered incidentally – meaning that they are found by chance during radiologic studies obtained for an unrelated medical condition. Others are discovered because patients have the signs and symptoms of “hormone overload” – excessive amounts of normal hormones that result in a variety of symptoms. Another cause of adrenal tumors is spread (metastasis) from another cancer (i.e.: breast, kidney, and thyroid).
The symptoms of adrenal tumors can include any of the following:
- No ailments
- High blood pressure (hypertension), fast heart rate (tachycardia), flushing, and sweating.
- Anxiety and emotional imbalance.
- Weight gain, lethargy (tiredness), humping of the shoulder, blue streaks on the abdomen
- Acne and facial hair; breast development.
Specific physical findings, blood tests, urine tests, and X-ray studies are crucial to the diagnosis of an adrenal mass. Most important is an MRI scan of the abdomen. A CT scan of the abdomen is also very helpful. For adrenal masses, we evaluate these X-ray studies for the presence of fat. The more fat in the lesion on MRI or Ct, the more likely the tumor is benign.
Most adrenal tumors are benign – meaning that they do not spread to other parts of the bodies. Many of these, however, can produce hormones that cause medical and physical ailments. Some conditions are listed below:
- Pheochromocytoma: can produce high blood pressure (hypertension), fast heart rate (tachycardia), flushing, and sweating. Approximately 10% of pheochromocytomas are malignant, meaning that they can spread to other parts of the body (a process known as metastasis). An MRI scan and urine tests for adrenaline and similar hormones are the best studies to diagnose a pheochromcytoma.
- Cushing’s Disease: can produce weight gain, lethargy (tiredness), humping of the shoulder, blue streaks on the abdomen, acne, and facial hair. Urine and blood tests will show elevated levels of cortosol.
- Aldosteronoma: can produce high blood pressure and decreased levels of potassium. Urine and blood tests are most useful for its diagnosis.
An algorithm for treating adrenal tumors is as follows:
This algorithm is quite simplified and every adrenal tumor must be evaluated on a case-by-case system. Surgeons in the Section of Urology at the University of Chicago are trained in the most up-to-date and technologically-advanced methods of treating kidney cancers. At you appointment, your surgeon will be glad to discuss all of these treatment options with you.
Most adrenal tumors are treated surgically. At the University of Chicago, we offer the latest and most comprehensive treatment for any type of adrenal tumor, including open and laparoscopic surgery.
Surgical Treatment Options for Adrenal Tumors
Surgery is the main treatment for adrenal tumors.
Adrenalectomy(click here for FAQs about Adrenalectomy)
- This involves removal of the entire adrenal and the surrounding fatty tissue (all contained within Gerota’s Fascia). This operation is used for adrenal tumors that are larger than 5cm or for smaller tumors that are suspicious for cancer or are producing elevated levels of hormones.
- Adrenalectomies are performed in a laparoscopic (minimally-invasive) manner, unless the tumor is very large or invades surrounding organs.
- If the tumor invades surrounding organs (such as the liver or spleen) or is involving the inferior vena cava, these structures may be removed in addition to the kidney. Depending upon the location and extent of such locally-advanced disease, open techniques are then used.
- Some patients may require drug treatments prior to surgery.
- Our anesthesiologists are specifically trained to manage patients undergoing adrenal surgery.