Adrenal Tumor Diagnosis, Growth, and Treatment Options

An adrenal tumor is a growth on one of the small hormone-producing glands above the kidneys. Many are benign and found incidentally on imaging, but careful testing is important to identify hormone-producing tumors and the less common cancers that need treatment.

Adrenal tumor overview

An adrenal tumor is an abnormal growth in an adrenal gland, the pair of triangular glands located above the kidneys. The adrenal glands make hormones that help regulate blood pressure, metabolism, the stress response, salt balance, and sex-hormone activity. An adrenal tumor may be benign, meaning noncancerous, or malignant, meaning cancerous.

Many adrenal tumors are discovered unexpectedly during a scan performed for another reason. These are often called adrenal incidentalomas. A scan alone cannot always establish the diagnosis, so clinicians consider the tumor’s size and appearance, whether it produces hormones, a person’s symptoms, and their medical history. The aim is to identify tumors needing treatment while avoiding unnecessary procedures for low-risk growths.

Common types include nonfunctioning adrenal adenomas, which do not make excess hormones; cortisol-producing adenomas; aldosterone-producing adenomas; and pheochromocytomas, which produce catecholamines. Treatment Options" class="ahp-ilk">Adrenocortical carcinoma is a rare cancer arising from the outer layer of the adrenal gland. Some tumors found near the adrenal gland may also represent metastases from another cancer, cysts, or other non-adrenal conditions.

Symptoms and hormone-related effects

Many adrenal tumors cause no symptoms. When symptoms occur, they are often related to excess hormone production rather than the physical presence of the tumor. A larger tumor can occasionally cause abdominal discomfort, back or flank pain, or a feeling of fullness, although these symptoms have many possible causes.

Excess cortisol can lead to weight gain around the abdomen and face, easy bruising, muscle weakness, high blood pressure, high blood sugar, mood changes, or bone loss. Excess aldosterone may cause difficult-to-control high blood pressure and low potassium, sometimes with weakness, cramps, or palpitations. These patterns can be associated with Cushing syndrome or primary aldosteronism, depending on the hormone involved.

Pheochromocytoma may cause episodes of headache, sweating, pounding heartbeat, tremor, anxiety-like sensations, or sudden rises in blood pressure. However, symptoms alone cannot diagnose an adrenal condition. Similar symptoms may arise from medications, stress, thyroid disorders, and many other health problems, so appropriate testing is essential.

How serious is a tumor on your adrenal gland?

How serious an adrenal tumor is depends mainly on whether it is cancerous, makes excess hormones, is growing, or has imaging features that are not reassuring. The majority of incidentally found adrenal masses are benign adenomas. Even a benign tumor may require treatment if it produces clinically important amounts of hormones.

Clinicians assess seriousness by reviewing the tumor’s size, density and shape on imaging, whether it has changed over time, and the results of hormone testing. A tumor with irregular features, signs of invasion into nearby tissues, or evidence of spread requires urgent specialist evaluation. By contrast, a small lesion with typical benign imaging characteristics and normal hormone results may only need follow-up or may not require repeat imaging at all, depending on the individual circumstances.

Adrenocortical carcinoma is rare but can be serious because it may grow locally or spread to other organs. Early assessment supports timely care. A person should not assume that an adrenal mass is cancerous, but should make sure recommended endocrine and imaging evaluation is completed.

Diagnosis and tests for an adrenal tumor

Evaluation usually begins with a medical history, physical examination, and review of the scan that detected the mass. CT and MRI can provide useful information about the tumor’s size, composition, and margins. In selected situations, functional imaging may be considered, particularly when a pheochromocytoma or cancer spread is suspected.

Hormone testing is an important part of assessment, including in people without obvious symptoms. Depending on the clinical situation, blood and urine tests may evaluate cortisol, catecholamine metabolites, aldosterone, renin, and sometimes sex hormones or steroid precursors. Testing is individualized because medications, blood pressure, potassium levels, and other medical conditions can affect interpretation.

Biopsy is not routinely used for a newly found adrenal tumor. It generally cannot reliably distinguish an adrenal adenoma from adrenocortical carcinoma, and it can be dangerous if pheochromocytoma has not first been excluded. A biopsy may be considered only in carefully selected cases, such as when imaging suggests the adrenal gland may contain metastasis from a known cancer and the result would change management.

Follow-up plans vary. If imaging and hormonal assessment support a benign, nonfunctioning adenoma, the doctor may recommend observation. If a tumor has uncertain features, repeat imaging or referral to an endocrinologist, endocrine surgeon, or oncology team may be appropriate.

How quickly do adrenal tumors grow?

Adrenal tumors do not all grow at the same rate. Many benign adrenal adenomas remain stable for years or grow very slowly. A lack of growth is reassuring, but growth rate is only one part of the overall assessment; hormone production and imaging appearance are equally important.

A tumor that enlarges noticeably on follow-up imaging, develops a more irregular appearance, or is associated with new hormone-related symptoms needs re-evaluation. Faster growth can raise concern for malignancy, although it does not prove cancer. Conversely, some cancers may not show dramatic growth over a short interval.

Doctors choose the timing of repeat scans according to the original imaging findings, tumor size, hormone results, and individual risk factors. Patients should avoid comparing scan reports without clinical guidance, as small measurement differences can occur because of scan technique and interpretation. The treating team can explain whether a change is meaningful and whether it affects the plan.

What are the treatment options for adrenal tumors?

Treatment depends on the exact type of adrenal tumor. Observation may be appropriate for a nonfunctioning tumor that has benign features on imaging and does not cause symptoms. Follow-up may include clinical review, hormone reassessment when indicated, and repeat imaging for lesions that are not clearly benign.

Surgery to remove the affected adrenal gland, called adrenalectomy, is commonly considered for hormone-producing tumors, tumors with concerning imaging features, enlarging tumors, and suspected adrenal cancer. Many suitable tumors can be removed with minimally invasive laparoscopic or robotic techniques. Open surgery may be preferred when a cancer is large, invasive, or requires wider removal of surrounding tissue. Adrenalectomy should be planned by surgeons experienced in adrenal disease.

Before surgery for pheochromocytoma, medications are used to stabilize blood pressure and reduce surgical risk. For aldosterone-producing tumors, medicines that block aldosterone may be used when surgery is not appropriate or while assessment is underway. Cortisol-producing tumors also require careful perioperative planning because hormone levels may need support after the tumor is removed.

For adrenocortical carcinoma, treatment may include surgery, adjuvant medication such as mitotane in selected cases, and systemic therapy or radiation in certain situations. The best approach depends on stage, whether complete surgery is possible, hormone production, and the person’s overall health. Cancer care may also include chemotherapy when recommended by an oncology team.

What are some new treatment options for adrenal cancer?

For adrenocortical carcinoma, complete surgical removal remains the main potentially curative treatment when the cancer is localized and operable. Modern care increasingly relies on multidisciplinary planning, with endocrine surgeons, medical oncologists, endocrinologists, radiologists, pathologists, and radiation specialists reviewing complex cases together.

For advanced disease, treatment may include mitotane, combination chemotherapy, radiation therapy for selected local problems, and supportive treatment for hormone excess. Molecular testing of tumor tissue may sometimes help identify clinical-trial opportunities or clarify whether a hereditary cancer syndrome should be considered. These options are not appropriate for every patient, and their availability and likely benefit depend on the individual cancer.

Immunotherapy and targeted treatments are being studied and may be used in selected patients, often in specialist centers or clinical trials. Evidence continues to evolve, and response can vary substantially. A specialist can explain established therapies, potential trial options, expected side effects, and the goals of treatment for a particular stage of disease.

When to seek medical care

A person should arrange medical review after an adrenal tumor is identified on imaging, even if they feel well. Timely assessment is particularly important for newly difficult-to-control high blood pressure, low potassium, unexplained episodes of palpitations and sweating, rapid changes in weight or muscle strength, or symptoms suggesting excess cortisol.

Urgent medical care is appropriate for severe chest pain, fainting, severe shortness of breath, a very severe headache, weakness on one side of the body, or other sudden symptoms that could reflect a medical emergency. These symptoms are not specific to adrenal tumors and should be assessed promptly.

There is no proven lifestyle measure that prevents most adrenal tumors. Keeping regular medical appointments, managing blood pressure and diabetes, reporting new symptoms, and taking medicines as prescribed can support overall health during evaluation and treatment. Acıbadem Health Point’s multidisciplinary specialists and JCI-accredited hospitals diagnose and treat adrenal conditions for international patients.

Frequently asked questions