Adrenal

Adrenal Cancer
The adrenals are small glands that sit above each of the kidneys. The kidneys are responsible for cleaning and purifying the blood and are located inside the upper part of the abdomen.

The adrenal gland is made up of two parts. The outer part, called the cortex, produces certain hormones for the body. This is where adrenal cortical tumors can develop; however, they are rare.

Our team of experts provides comprehensive care in the treatment of adrenal tumors cancer care. Benign adenomas can be surgically treated both laparoscopically and through open surgery.

Adrenal Cortex Tumors
There are two main types of adrenal cortex tumors. Most are benign (non-cancerous) and are called adenomas.

1. Adrenal cortex adenomas: Most tumors of the adrenal cortex are benign adenomas. These are small tumors, usually less than five centimeters (about two inches) in diameter. They usually occur in only 1 adrenal gland, but sometimes affect both glands.
2. Adrenal cortical cancer: The type of cancer that develops in the cortex of the adrenal gland is called adrenal cortical carcinoma. Generally, adrenal cortical cancers are much larger than adrenal adenomas. An adrenal tumor larger than five or six centimeters (about two to two and one half inches) is usually malignant or cancerous. In one study, the average size was about four to five inches.

Symptoms
Most people with adrenal adenomas have no symptoms. Some of these adenomas are found when CT or MRI scans of the abdomen are ordered because of unrelated health problems. Many are "nonfunctional" adenomas; the cells are not producing enough steroid hormones to cause any symptoms.

Adrenal cortical cancers usually are discovered because the patient has a variety of symptoms. These may include:

• body changes such as weight gain and fluid retention
• excess facial or body hair growth in women
• early puberty in children

These symptoms are caused by excessive amounts of hormones produced by the tumor.

Other symptoms may include:

• pain
• a feeling of fullness
• weight loss

These symptoms may occur because the tumor has grown and causes symptoms by pressing on other organs in the area.

Diagnosis
Your doctor will ask for a complete medical history and will perform a thorough physical examination. Diagnostic tests may include:

• CT scan
• MRI
• MIBG scan
• Percutaneous or laparoscopic biopsies

Treatment for Adrenal Adenomas
Adenomas are usually treated by removing the adrenal gland that contains the adenoma. The operation can be done through an incision in the front of the abdomen or in the back.

Laparoscopic Adrenalectomy
A technique called laparoscopic adrenalectomy allows the surgeon to remove the adrenal gland with an adenoma through an instrument called a laparoscope. The laparoscope is a thin tube with a tiny video camera on the end. Once inserted through a small surgical opening in the patient's side, it allows the doctors to see where the tumor is growing. Other instruments inserted through this tube or through other very small incisions are used to remove the adrenal gland.

In some cases, adrenal adenomas that cause hormone-related symptoms can be treated with medications that stop the production or actions of these hormones. There are also small adenomas, discovered while looking for something else, that are not causing any symptoms. These do not need any treatment.

Treatment for Adrenal Cortical Cancers
In most cases, your doctor will recommend surgery to remove the tumor as well as the adrenal gland. Your doctor may choose a laparoscopic approach for surgery. This approach usually speeds healing and recovery after the surgery. Chemotherapy may be recommended to halt the growth of cancer throughout the body.