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Fact Sheet

Adrenal Incidentaloma

  • Editors
  • Lynnette Nieman, MD

    Phyllis Speiser, MD

    William F. Young, Jr., MD

What is an adrenal incidentaloma?

An adrenal incidentaloma is an unsuspected tumor in one or both of your adrenal glands. This type of tumor is usually found by chance during an imaging test, such as an ultrasound or CT scan, for another condition. A tumor can be benign (non-cancerous) or malignant (cancerous).

What are the adrenal glands and what do they do?

You have two adrenal glands—one on top of each of your kidneys. Your adrenal glands make several important hormones. If your adrenal glands make too little or too much of these hormones, you can get sick.

DID YOU KNOW?

Your risk for an adrenal incidentaloma increases as your get older.

What causes an adrenal incidentaloma?

There are a number of causes. Some causes can make your adrenal glands produce too much of a hormone. This type of tumor is called a hormonally active or functional tumor. Hormonally active causes include

Other types of causes do not result in excess hormone production. This type of tumor is called a non-functional tumor. Causes include

Name Function
Cortisol Helps the body cope with stress, illness, and injury.  Helps regulate blood sugar (glucose) and blood pressure levels. 
Aldosterone Helps keep a proper balance of salt and water in the body.  Regulates blood volume, blood pressure, and levels of potassium in the blood.
Adrenal androgens Contribute to pubic and armpit hair growth and body odor in men and women. 
Epinephrine (adrenaline) In response to fear, stress, or excitement, raises blood pressure, increases heart rate, helps the body take in oxygen, and increases blood supply to the muscles.
Norepinephrine (noradrenaline) Helps with body function for regular activities. 

What are the symptoms of an adrenal incidentaloma?

Symptoms vary depending on whether the tumor is non-functional or functional, and which, if any, hormones are produced in excess.

Symptoms of too much cortisol can include

High levels of cortisol can also cause high blood pressure, high blood sugar, and low bone density (when the tissue inside your bones starts to thin).

Symptoms of too much norepinephrine or epinephrine can include

High levels of these hormones can also cause high blood pressure.

High levels of aldosterone can cause high blood pressure, which can be life-threatening if not treated, and sometimes muscle weakness.

How is an adrenal incidentaloma evaluated?

Your doctor will evaluate your tumor to identify its cause and hormone production. This may include

Your doctor also will need to know your family history of adrenal tumors, other kinds of tumors, syndromes that come with tumors, high blood pressure, or Cushing syndrome.

What is the treatment for an adrenal incidentaloma?

About 85 percent of adrenal tumors are non-functioning and may not need treatment. Sometimes surgery is needed to remove the tumor, or one or both adrenal glands. Your medical team will decide whether you need surgery based on your type of tumor (benign or cancerous) and whether it is producing hormones. Some people may need hormone treatment. If you have an inherited tumor syndrome, you may need genetic counseling.

If you’ve had an adrenal incidentaloma, you may need regular follow-up, perhaps for several years.

Questions to ask your doctor

Resources: