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ADRENAL TUMORS
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.
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.
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.
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