5th April 2024

Adrenal Tumours

Background

Adrenal tumours are excess growth of tissue within one or more of the adrenal glands. These tumours are often benign and are found incidentally on imaging. Others can be non-cancerous hormone secreting tumours e.g., the aldosterone secreting tumours seen in Conn’s syndrome. Some tumours are cancerous but unlikely to spread, e.g., phaeochromocytoma. However, adrenal metastases from cancers that started elsewhere in the body include lung cancer, kidney cancer and malignant melanoma.

Tumour types

Phaeochromocytomas are nearly always benign adrenal tumours that secrete excess catecholamines, e.g., adrenaline and noradrenaline. Symptoms include headaches, palpitations and diaphoresis. The tumour is unresponsive to the negative feedback loop of the hypothalamic-pituitary-adrenal axis. Diagnosis is through measuring catecholamine levels and treatment is based around surgical removal of the tumour.

Conn’s syndrome is caused by solitary aldosterone-secreting tumours that present with symptoms of hyperaldosteronism: polydipsia, polyuria, and weakness. Definitive treatment is laparoscopic surgery to remove the affected gland preceded by four weeks of medical management to control BP.

Adrenocortical carcinomas are very rare tumours that start in the adrenal cortex. Around two thirds secrete adrenal hormones such as cortisol and aldosterone. They are sometimes linked with rare genetic disorders such as Li Fraumeni syndrome and MEN type 1.

Neuroblastomas are tumours derived from neural tissue and most often present in children under five years old. The adrenal glands are one of the most common sites for the cancer to originate from and presentation is often with an abdominal mass.

References

• Adrenal gland tumours. Last reviewed 2ⁿᵈ Dec 2021. Available at: Adrenal gland tumours | Cancer Research UK
• What is neuroblastoma? Last reviewed 23ʳᵈ Feb 2021. Available at: What is neuroblastoma? | Cancer Research UK