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.
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:
Conditions caused by too much cortisol
A pheochromocytoma: a rare tumor in the adrenal glands that leads to too much epinephrine and norepinephrine
An inherited condition in which the adrenal glands make too little cortisol and aldosterone, and too much androgen
Cancer of the adrenal gland with too much cortisol, adrenal androgens, and/or aldosterone
Other types of causes do not result in excess hormone production. This type of tumor is called a non-functional tumor. Causes include:
Even when discovered incidentally, adrenal tumors may cause symptoms. 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 aldosterone can cause high blood pressure, which can be life-threatening if not treated, and sometimes muscle weakness.
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.
About 85% 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.
The Hormone Health Network is the public education affiliate of the Endocrine Society dedicated to helping both patients and doctors find information on the prevention, treatment and cure of hormone-related conditions.
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