Adenoma of the Adrenal Gland

Definition

Definition of Adenoma of the Adrenal Gland
Adrenal masses (AMs) are often discovered incidentally and are then termed adrenal incidentalomas (AIs). They are often discovered after an imaging procedure is performed that is unrelated to the adrenal gland. Usually, the patient has no signs of hormonal excess or obvious underlying malignancy. Incidence has been increasing proportionally to the use of radiographic imaging, as shown in the images below. Less commonly, AMs are discovered as part of the clinical workup for suspected adrenal disease (eg, Cushing syndrome).

Symptoms

Symptoms of Adenoma of the Adrenal Gland
Majority of the adrenal adenoma patients do not display any detectable symptoms. However, proper medical examination will show abnormal production of steroid hormones. Among the most common abnormalities include the overproduction of cortisol, which is a type of steroid hormone that is involved in nenergy balance and stress responses. Quite rarely, adenomas may trigger bleeding and cause pain in the patient's back or flank.

Causes

Causes of Adenoma of the Adrenal Gland
Some studies report an association with chromosomal and genetic abnormalities (genes coding for p53 and p57). Tumor markers are also present in other syndromes. The multiple endocrine neoplasia (MEN1) gene is linked to multiple endocrine neoplasia type 1. The aldosynthase/11-beta hydroxylase hybrid gene is associated with glucocorticoid-remediable hyperaldosteronism.

Diagnosis

Diagnosis of Adenoma of the Adrenal Gland
Most of the patients with adrenal adenoma are diagnosed by chance when an MRI or CT scan is performed for some unrelated symptoms.

Treatment

Treatment of Adenoma of the Adrenal Gland
Treatment for functioning adrenal adenoma involves the removal of the affected gland through surgery. There are some medical facilities that uses laparoscopic adrenalectomy, although this type of surgical approach is still not well-establised to be better than the standard surgery.

Prognosis

Prognosis of Adenoma of the Adrenal Gland
Generally, the prognosis is excellent, but it depends on the type of underlying adrenal disease.

Approximately 80% of AAs are nonfunctional (hormonally silent) and benign. Twenty percent of AAs are either functional (hormonally active) or malignant and require further evaluation and treatment to avoid medical complications.

Patients with a previous history of cancer have a clinical course dictated by the primary tumor. Patients with adrenal cortical carcinomas have poor clinical outcomes, usually a 2- to 5-year 50% overall survival rate.

Prevention

Prevention of Adenoma of the Adrenal Gland
Consult with your doctor.