Benign Adrenal Tumor

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The adrenal glands produce hormones that control our body’s metabolism, stress level, blood pressure, heart rate, sexual development, etc. They are a part of the endocrine glands (the system that produces hormones directly into the bloodstream).  The adrenal glands are two in number, each located at the top of the left and right kidneys. They […] Read More

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Benign Adrenal Tumor

The adrenal glands produce hormones that control our body’s metabolism, stress level, blood pressure, heart rate, sexual development, etc. They are a part of the endocrine glands (the system that produces hormones directly into the bloodstream).  The adrenal glands are two in number, each located at the top of the left and right kidneys. They are triangular, and each is about half an inch tall and 3 inches long.  Anatomy of the adrenal gland Picture Courtesy: MedlinePlus The adrenal glands each have two parts: 
      • The cortex, which is the outer part of the gland, produces hormones such as aldosterone, cortisol, testosterone in males, and estrogen in females. These hormones control blood level and pressure, metabolism, and the body’s use of fats, carbohydrates, proteins, vitamins, etc.
      • The medulla is the inner part and produces dopamine and catecholamines (which consist of adrenaline/epinephrine and noradrenaline/norepinephrine). These hormones control transmission to the brain through movement, attention, learning, pleasure, stress, etc. They also affect blood pressure and heart rate.
Benign Adrenal gland tumor comparison Picture Courtesy: The adrenal glands can develop tumors when their cells begin to mutate and take a different form (tumor). Adrenal gland tumors can either be malignant (cancerous) – growing, multiplying, and spreading to other body parts, or benign (non-cancerous) – do not multiply or spread. The majority of adrenal tumors are benign adrenal tumors.   

What Are Benign Adrenal Tumors?

Benign adrenal tumors are non-cancerous tumors or masses that form in the adrenal glands. These tumors can either be non-functional or functional. 
      • Non-functional (inactive) benign adrenal tumors do not produce hormones. This type hardly causes any problems and only takes up space in the glands.
      • Functional (active) benign adrenal tumors produce and secrete the same hormones as the part of the adrenal glands they occupy. And the excess secretion leads to a lot of symptoms. These tumors are more common than non-functional tumors.
Benign adrenal tumors form in each part of the adrenal glands, and the tumors that form in the parts are named differently. They include: 
      • Adenoma; tumors that form in the cortex.
      • Pheochromocytoma; tumors that form in the medulla. 

What are the risk factors associated with Benign adrenal tumors?

Risk Factors The factors that lead to the development of benign tumors in the adrenal glands are mainly genetic/hereditary conditions. They include:
      • Multiple Endocrine Neoplasia Type 1 & 2 (MEN1 and MEN2); benign tumors in the endocrine system
      • Familial Adenomatous Polyposis (FAP); benign polyps in the respiratory tract and large intestine.
      • Paraganglioma syndrome; benign tumors in the paraganglia (a group of cells in the abdomen)
      • Neurofibromatosis Type 1 or Von Recklinghausen’s disease.
      • Von-Hippel-Lindau disease.
      • Beckwith-Wiedemann syndrome
      • Li-Fraumeni syndrome 
      • Carney complex

Benign Adrenal Tumors in the Cortex

Functional tumors in the cortex lead to the secretion of excess cortex hormones, and each hormone produced in excess has its effect. They include:

1. Excess cortisol secretion leads to “Hypercortisolism” or “Cushing’s Syndrome.” The symptoms specific to this condition are as follows:

      • High blood pressure or hypertension
      • High blood sugar levels, which can lead to diabetes. 
      • Visible stretch marks on the skin (purple, pink, bluish-red), mostly on the breasts, stomach, and thighs.
      • Skin becomes easily bruised.
      • Abdominal weight gain or obesity (pot belly)
      • Fat accumulation in the upper back, in the middle of the shoulders, and/or in the neck
      • Facial swelling; round, full, “moon” face.
      • Intolerance to glucose
      • Acne
      • Fatigue
      • Weak muscles
      • Uncontrollable mood swings.

2. Excess secretion in the aldosterone can lead to “Hyperaldosteronism” or “Conn’s Syndrome.” The symptoms may include:

      • Low potassium level
      • Osteoporosis; bone fractures
      • High blood pressure
      • Muscle cramps, numbness, and in rare cases, paralysis.
      • General body weakness and fatigue.

3. The excessive secretion of androgens/testosterone in females and estrogen in males can lead to the following signs:

      • Genitalia changes
      • Change in sex drive (libido)
      • Virilization (increased masculine features) in women and increased feminine features in men.
In women, In men, 
      • Feminine tone (lighter voice)
      • Enlarged and tender breasts
      • Lower sex drive.
      • Erectile problems.

Benign Adrenal Tumors in the Medulla

With too much catecholamine and dopamine, the patient may develop symptoms such as:
      • Heart palpitations; irregular and rapid heartbeats.
      • Negative moods like mental attacks of nervousness, panic, fear, anxiety, and depression.
      • Skin flushes and paleness
      • Excessive sweating
      • Sleep disorders like insomnia
      • Lightheaded, dizzy, and tremor spells when standing.
      • Weight loss
      • Headaches
      • Weakness
      • High blood pressure.
Also, you may experience the symptom most associated with the presence of growths in the body, which is “abdominal pain.”  

What are the diagnostic steps in diagnosing Benign adrenal tumors?

Diagnosis The doctor will go through the patient’s medical history to check for genetic disorders and inquire about the symptoms the patient is experiencing. Some tests used to diagnose benign adrenal tumors may include:

How do we treat Benign adrenal tumors?

Treatment Non-functioning benign adrenal tumors do not necessarily need treatment because they rarely are disruptive, do not have symptoms, and are static in growth once they develop. At the same time, the doctor monitors them to see if they keep growing. If they keep growing, then the doctor will advise the patient to undergo surgery to remove them (Adrenalectomy). On the other hand, however, functional benign adrenal tumors need to be taken care of because they come with a lot of inconveniences. The symptoms they bring up due to their excessive production of hormones affect their quality of life. There are two treatments:
      • Hormonal Therapy
Medications such as metyrosine, metyrapone, streptozocin, spironolactone, etc., are used to stop the production of excess hormones and create hormonal balance.
      • Surgery
This is done to remove the benign tumor from the adrenal glands. Depending on the location and size, the surgeon can decide to perform laparoscopic surgery, using laparoscopy and surgical tools, through small incisions on the abdomen to remove the tumors, or could perform open surgery. After the surgery, it takes 2 to 8 weeks to recover. The duration is based on the type of surgery undertaken. All post-operative instructions given by the surgeon must be followed strictly.


What are the most common Signs and Symptoms associated with Benign adrenal tumors?

The symptoms of benign adrenal tumors depend on the growing type of tumor. 

Non-functional tumors are rare and often don’t give any signs or symptoms, except in some cases where the patient complains of abdominal pain. 

However, functional tumors, both those that grow in the cortex (adenoma) and those in the medulla (pheochromocytoma), give symptoms because they produce extra and excessive hormones the body does not need.


What are the most common causes of Benign adrenal tumors?

Benign tumors in the adrenal glands start when the cells in the glands begin to grow abnormally or form masses. But what makes the cells mutate and begin to form tumors is unknown. However, certain factors contribute to people developing these tumors, such as hereditary, obesity, tobacco usage, and abnormal genetic conditions may increase the risk of causing benign adrenal tumors.


Where are the adrenal glands located?

The adrenal glands are located at the top of both kidneys.


What are the types of hormones produced by adrenal glands?

The function of the adrenal glands is to produce hormones that control most body functions and work closely with the brain. 

The hormones the adrenal glands produce are based on their two parts; the cortex and the medulla.

The cortex secretes hormones, namely:

      • Aldosterone
      • Cortisol
      • Androgen/Testosterone
      • Estrogen

The medulla secretes hormones, namely:

      • Dopamine
      • Catecholamine, which includes adrenaline and noradrenaline.


Where is aldosterone produced?

Aldosterone is a hormone produced in the cortex, which is the outer part of the adrenal glands.


What does aldosterone do?

The function of aldosterone is to control and regulate the balance of potassium and sodium in the blood.


Where is epinephrine produced?

Epinephrine, also known as adrenaline, is a hormone produced in the medulla, which is the inner part of the adrenal glands.


What is pheochromocytoma?

This is a benign or malignant tumor found in the medulla of the adrenal glands.


Can adrenal gland tumors be prevented?

No. One cannot prevent these tumors because the risk factors for adrenal tumors often depend on the genes.


What is the prognosis of patients with Benign adrenal tumors after surgery?

Patients who underwent adrenalectomy (removal of adrenal gland and tumor) have an excellent prognosis after the surgery. Removing the affected adrenal gland often relieves the symptoms related to functional adrenal tumors.