About the adrenal glands
Each person has 2 adrenal glands. One is on top of each kidney. The body has 2 kidneys. The adrenal glands are small, yellowish in color, and normally weigh about 10 grams. These glands are important to the body’s endocrine system. The endocrine system is made up of tissues and organs that produce hormones. Hormones are chemical substances that are carried through the bloodstream to have a specific effect on the activity of other organs or cells in the body.
Each adrenal gland has 2 main parts that function separately:
- Adrenal cortex. The outer part of the adrenal gland is called the cortex. The adrenal cortex makes 3 main hormones: cortisol, aldosterone, and dehydroepiandrosterone (DHEA). These hormones carefully control metabolism, blood pressure, and body features, such as hair growth and body shape.
- Adrenal medulla. The inner part of the adrenal glands is called the medulla. The adrenal medulla makes 3 hormones: epinephrine, norepinephrine, and dopamine. These hormones, often called catecholamines, control the body’s responses to stress, including the “fight or flight” adrenaline surge.
About adrenal gland tumors
A tumor begins when healthy cells change and grow out of control, forming a mass. A tumor can be cancerous or benign. A cancerous tumor is malignant, meaning it can grow and spread to other parts of the body. A benign tumor means the tumor can grow but will not spread.
An adrenal gland tumor can sometimes produce too much of a hormone. When it does, the tumor is called a “functioning tumor.” An adrenal gland tumor that does not produce hormones is called a “non-functioning tumor.” The symptoms and treatment of an adrenal gland tumor depend on:
- Whether the tumor is functioning or non-functioning
- Which hormone(s) are produced in excess?
- Whether the tumor started in the adrenal gland or spread from another organ
Functional adrenal gland tumors may produce any hormone made in the adrenal gland. In rare cases, they may produce more than 1 hormone.
This section focuses on primary adrenal gland tumors. A primary adrenal gland tumor starts in an adrenal gland. An adrenal gland tumor may also result from a cancer that began in another organ, such as the lungs, and then spread to the adrenal gland through a process called metastasis.
Primary adrenal gland tumors include the following:
- Adenoma. This is the most common type of adrenal gland tumor. Adenoma is also called an adrenocortical adenoma. It is a noncancerous tumor of the adrenal cortex that can be functioning or non-functioning. A small adenoma that does not cause symptoms and is not producing hormones excessively often does not need treatment. Adenoma that produces too much of a blood pressure hormone called aldosterone is called aldosteronoma. Adenoma that produces too much cortisol results in a syndrome called Cushing’s syndrome, which is characterized by weight gain, easy bruising, high blood pressure, and diabetes.
- Adrenocortical carcinoma. Adrenocortical carcinoma begins in the adrenal cortex. It is rare, but it is the most common type of cancerous adrenal gland tumor. Adrenocortical carcinoma is also known as adrenal cortical carcinoma. Approximately 1 to 2 people out of every 1 million people develop adrenocortical carcinoma. Adrenocortical carcinoma can be a functioning or non-functioning tumor. If the tumor is functioning, it may produce more than 1 hormone.
- Neuroblastoma. This is a type of childhood cancer that can begin in the adrenal medulla. Learn more about childhood neuroblastoma.
- Pheochromocytoma. This type of neuroendocrine tumor most often begins in the adrenal medulla and is characterized by high blood pressure, a rapid heartbeat, and sweating. Learn more about pheochromocytoma
How many people are diagnosed with an adrenal gland tumor?
A primary adrenal gland tumor is very uncommon. Each year, an estimated 600 people in the United States are diagnosed with adrenocortical carcinoma. This type of cancer is much less common than an adrenal adenoma, which is a noncancerous tumor that is found most commonly in middle-aged and older adults. The average age of a person diagnosed with an adrenal gland tumor is 46 years. However, these tumors can occur at any age. See the Introduction for more information about these types of adrenal gland tumors.
What is the survival rate for an adrenal gland tumor?
There are different types of statistics that can help doctors evaluate a person’s chance of recovery from an adrenal gland tumor. These are called survival statistics. A specific type of survival statistic is called the relative survival rate. It is often used to predict how having a tumor may affect life expectancy. The relative survival rate looks at how likely people with an adrenal gland tumor are to survive for a certain amount of time after their initial diagnosis or start of treatment compared to the expected survival of similar people without this tumor.
Example: Here is an example to help explain what a relative survival rate means. Please note that this is only an example and not specific to this type of cancer. Let’s assume that the 5-year relative survival rate for a specific type of cancer is 90%. “Percent” means how many out of 100. Imagine there are 1,000 people without cancer, and based on their age and other characteristics, you expect 900 of the 1,000 to be alive in 5 years.
Imagine that there are another 1,000 people similar in age and other characteristics as the first 1,000, but they all have the same specific type of cancer that has a 5-year survival rate of 90%. This means it is expected that 810 of the people with the specific cancer (90% of 900) will be alive in 5 years.
It is important to remember that statistics on the survival rates for people with an adrenal gland tumor are only an estimate. They cannot tell an individual person if the tumor will or will not shorten their life. Instead, these statistics describe trends in groups of people previously diagnosed with the same disease, including specific stages of the disease.
The 5-year relative survival rate for adrenocortical carcinoma in the United States is 50%.
The survival rates for an adrenal gland tumor vary based on several factors. These include the stage of the tumor, a person’s age and general health, and how well the treatment plan works. Another factor that can affect outcomes is whether the tumor produces hormones.
If an adrenal gland tumor is diagnosed and treated before it has spread outside the adrenal gland, the 5-year relative survival rate is 74%. In the past, approximately 30% of adrenocortical cancers were diagnosed at this stage. However, advances in imaging tests mean more people with an adrenal gland tumor are now being diagnosed at earlier stages. If the cancer has spread to the surrounding tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is 54%. If the cancer has spread to a distant part of the body, the 5-year relative survival rate is 38%.
Experts measure relative survival rate statistics for an adrenal gland tumor every 5 years. This means the estimate may not reflect the results of advancements in how an adrenal gland tumor is diagnosed or treated over the last 5 years. Talk with your doctor if you have any questions about this information. Learn more about understanding statistics.
What are the risk factors for an adrenal gland tumor?
A risk factor is anything that increases a person’s chance of developing a tumor. Although risk factors often influence the development of a tumor, most do not directly cause a tumor. Some people with several known risk factors never develop a tumor, while others with no known risk factors do. However, knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.
People with certain inherited, or hereditary, conditions have a higher risk of developing an adrenal gland tumor. People with a high risk of developing an adrenal gland tumor because of their family history should be examined and evaluated by their doctor every year. Hereditary conditions that raise risk of adrenal gland tumors are:
- Multiple endocrine neoplasia type 2 (MEN2)
- Li-Fraumeni syndrome
- Von Hippel-Lindau syndrome
- Neurofibromatosis type 1
- Carney complex
- Succinate dehydrogenase mutations
What causes most cancerous adrenal gland tumors is not known.
Researchers continue to look into what factors cause adrenal gland tumors and what people can do to lower their personal risk. There is no proven way to completely prevent these tumors, but there may be steps you can take to lower your risk. Talk with your doctor if you have concerns about your personal risk of developing an adrenal gland tumor.
Adrenal Gland Tumor—Symptoms and Signs
What are the symptoms and signs of an adrenal gland tumor?
People with an adrenal gland tumor may experience one or more of the following symptoms or signs:. Symptoms are changes that you can feel in your body. Signs are changes in something measured, like taking your blood pressure or doing a lab test. Together, symptoms and signs can help describe a medical problem. Sometimes, people with an adrenal gland tumor do not have any of the symptoms and signs described below. Or, the cause of a symptom or sign may be a medical condition that is not a tumor.
- High blood pressure
- Low potassium level
- Heart palpitations
- Nervousness
- Feelings of anxiety or panic attacks
- Headache
- Heavy sweating/perspiration
- Diabetes
- Abdominal pain
- Unexplained weight gain or weight loss
- Weakness
- Abdominal stretch marks
- Excessive hair growth
- Changes in the genitals
- Unusual acne
- Change in libido (sex drive)
In addition, the specific tumor type of pheochromocytoma may cause dangerous surges of the hormones that regulate blood pressure and the body’s response to stress. A hormonal surge can cause blood pressure to rise very quickly, increasing the risk of a heart attack, stroke, hemorrhage, or sudden death.
If you are concerned about any changes you experience, please talk with your doctor. Your doctor will try to understand what is causing your symptom(s). They may do an exam and order tests to understand the cause of the problem, which is called a diagnosis.
If a tumor is diagnosed, relieving symptoms remains an important part of medical care and treatment. Managing symptoms may also be called “palliative and supportive care,” which is not the same as hospice care given at the end of life. This type of care focuses on managing symptoms and supporting people who face serious illnesses, such as a tumor. You can receive palliative and supportive care at any time during treatment. Learn more in this guide’s section on Coping with Treatment.
Be sure to talk with your health care team about symptoms you experience, including any new symptoms or a change in symptoms.
Adrenal Gland Tumor: Diagnosis
Doctors use many tests to find, or diagnose, a tumor. They also do tests to learn if a tumor is cancerous and, if so, whether it has spread to another part of the body from where it started. If the tumor does spread, it is called metastasis. Some tests may also determine which treatments may be the most effective.
To diagnose an adrenal gland tumor, the doctor will do blood and urine tests (see below) to look for the presence of certain substances to help determine whether the tumor is functional or nonfunctional (see Introduction). Imaging tests show pictures of the inside of the body and may be used to see if a cancerous tumor has spread. A computed tomography (CT or CAT) scan or a magnetic resonance imaging (MRI) scan (see below) may be useful in making a diagnosis and finding out whether an adrenal gland tumor is cancerous. Doctors may also do tests to learn which treatments could work best.
How an adrenal gland tumor is diagnosed
There are different tests used for diagnosing an adrenal gland tumor. Not all the tests described here will be used for every person. Your doctor may consider these factors when choosing a diagnostic test:
- The type of tumor suspected
- Your signs and symptoms
- Your age and general health
- The results of earlier medical tests
How an adrenal gland tumor is treated
For an adrenal gland tumor, different types of doctors who specialize in tumors, called oncologists, often work together to create a patient’s overall treatment plan that combines different types of treatments. This is called a multidisciplinary team. Your health care team may also include other health care professionals, including physician assistants, nurse practitioners, oncology nurses, social workers, pharmacists, counselors, dietitians, physical therapists, occupational therapists, and others. Learn more about the clinicians who provide care for people with a tumor.
Up to 30% of adrenal tumors that produce catecholamines (pheochromocytomas) may be linked to a genetic syndrome (see Risk Factors). When planning treatment, it may be helpful to talk with a genetic counselor to learn whether the tumor is associated with a specific syndrome. If you are diagnosed with an adrenal gland tumor, it is important to learn if any other members of your family may have had any types of endocrine disease in the past. If so, the syndrome may affect other members of your family, and specific genetic tests may be recommended for them. Learn more about genetic testing.
Treatment options and recommendations depend on several factors, including the type and stage of the tumor, possible side effects, and the patient’s preferences and overall health. Take time to learn about all of your treatment options and be sure to ask questions about things that are unclear. Talk with your doctor about the goals of each treatment and what you can expect while receiving treatment. These types of conversations are called “shared decision-making.” Shared decision-making is when you and your doctors work together to choose treatments that fit the goals of your care. Shared decision-making is important for adrenal gland tumors because there are different treatment options. Learn more about making treatment decisions.
The common types of treatments used for an adrenal gland tumor are described below. Your care plan also includes treatment for symptoms and side effects, an important part of care.
