What is an adrenal adenoma?

An adrenal adenoma is a benign or noncancerous tumor of the adrenal gland, located just above the kidney. Some adrenal adenomas, called nonfunctioning adrenal adenomas, don't secrete hormones, but others do. Depending on the type of hormone secreted by an adrenal adenoma, the tumor can cause different medical problems in the patient.

Adrenal adenomas tend to have a genetic basis and usually only appear in adults. The risk of developing an adrenal adenoma increases with age, and approximately 6% of patients older than 60 years have an adrenal adenoma. There is currently no known prevention for adrenal adenomas. Most adrenal adenomas are discovered by computed tomography (CT) or magnetic resonance imaging (MRI) scans of the abdomen for unrelated reasons.

If an adrenal adenoma releases cortisol, the patient may develop Cushing's Syndrome, also known as hypercorticism or hyperadrenocorticism. Cushing's syndrome is characterized by excess cortisol in the blood, and symptoms include excessive sweating, rapid weight gain, thinning of the skin and mucous membranes, and growth of facial hair. Patients with Cushing's syndrome characteristically gain weight in the torso and face, but not in the extremities, and develop fat pads along the back of the neck and collarbone, a symptom called the buffalo hump. Cushing's syndrome can also cause various skin disorders, heart disease, diabetes mellitus, high blood pressure, gastrointestinal disorders, impaired wound healing, and osteoporosis. Psychological problems can also occur, such as insomnia, loss of libido, depression, anxiety, and psychosis.

If an adrenal adenoma releases aldosterone, the patient may have Conn's syndrome or primary aldosteronism. Conn's syndrome causes sodium retention and hypocalcemia, or low calcium levels. Symptoms can include high blood pressure, muscle cramps and weakness, and headache. Finally, an adrenal adenoma may secrete androgens, leading to hyperandrogenism. Hyperandrogenism can cause excessive growth of body hair, loss of hair growth on the scalp, a deep voice, acne, obesity, infertility, and increased muscle mass. In women, it can also cause the uterus or breasts to shrink.

If an adrenal adenoma is functioning or releasing hormones of any kind, the resulting symptoms can be treated by surgical removal of the adenoma or adrenalectomy. The adenoma is usually small enough to be removed laparoscopically, in which the tumor is removed through very small incisions. Eighty percent of adrenal adenomas do not function and do not cause any harm to the patient.

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