Adrenal masses are tumors that involve the adrenal glands, paired organs that secrete several hormones and rest above the kidneys.
These masses are typically discovered incidentally on abdominal imaging obtained for another reason. Over 5% of the population are affected by adrenal masses. Although most adrenal masses are benign, evaluation is important to ensure that the tumor is not cancerous and is not secreting too much adrenal hormones (including cortisol, catecholamines, aldosterone). Excessive hormone is secreted from about 10% of adrenal masses leading to imbalances may cause high blood pressure, headaches, sweating, facial flushing, and body composition changes such as weight gain.
Causes and Risk Factors
Most adrenal masses occur sporadically, or randomly, but some are linked to certain genetic syndromes.
When to Speak with a Urologist about Adrenal Masses
You should talk to a Urologist about adrenal masses if an adrenal tumor over 1 centimeter in size was discovered on imaging.
What to Expect when Seeking Treatment
In addition to a history and physical examination, initial assessment includes specialized imaging with CT or MRI to rule out cancer and blood testing to rule out excess hormone production. Of note, the blood testing often requires taking a single pill called dexamethasone at night around 11pm before the blood draw the following morning around 8am.
Most adrenal masses are not concerning for malignancy and not hormonally overactive. Consequently, most adrenal lesions never require any treatment at all. The standard treatment for most hormonally active tumors and those concerning for cancer is surgical removal. Minimally invasive techniques, such as laparoscopy and robot-assisted surgery, may be employed in the surgical treatment of adrenal masses. This technology can shorten recovery time and limit pain following surgery. Preoperative medical control of medical issues like high blood pressure may be required prior to surgery.