Adrenal glands, also known as suprarenal glands are located on the top of both kidneys. They are triangular shaped glands. An adrenal gland is made of two main parts – Adrenal Cortex and Adrenal Medulla. The role of the adrenal glands in our body is to release certain hormones directly into the bloodstream. These hormones help to regulate our metabolism, immune system, blood pressure, our body response to stress and regulate various other essential functions.
Enlargement of adrenal gland can be due to multiple reasons. Common causes are adrenal adenoma, which are benign in nature, adrenocortical carcinoma, pheochromocytoma (tumor arising from adrenal medulla), Congenital Adrenal Hyperplasia, Metastasis from other carcinoma, infections like tuberculosis or fungal infection or infiltrative disorders like lymphoma etc.
Adrenal tumors need to be evaluated thoroughly. These are done by a Medical Endocrinologist. After evaluation, if surgery is required, it will be done by Surgical endocrinologist.
Most of the time, benign adrenal adenoma is diagnosed incidentally, when imaging is done for other indications. If an adrenal tumor produces hormones like cortisol, aldosterone, DHEAS or adrenaline, patients can present with symptoms due to hypersecretion of these hormones. Depending on the hormones involved, this can cause symptoms such as Abnormal Weight gain, proximal Muscle weakness, purplish striae, increased Blood pressure, Paroxysms (episodes of very high blood pressure, fast heart rate, sweating, and headaches), deep voice and increased hair growth, usually on the face (in women). Sometimes, patients can present with abnormal pain in the abdomen or severe weight loss.
We need to evaluate whether the adrenal tumor is malignant or benign, functioning or non-functioning. If possible, all functioning benign tumors will be treated by surgical removal of the respective gland. Non-functioning benign adenoma can be followed periodically, if there is significant increase in size, it can be treated surgically. Malignant tumors of the adrenal gland will require surgical removal of the tumor. After surgery, they may require chemotherapy or radiotherapy.
Complete evaluation of adrenal tumor is being done at MAGNA. Decisions to follow up without surgery or the need for surgery will be decided based on the laboratory investigations and imaging. Medical therapy for functionally active tumors is being given at MAGNA. Post-surgery follow up and hormone replacement if required are also done at MAGNA.
Treatment of adrenal tumor depends on the aetiology and functional status of the tumor. Benign adrenal adenoma can be followed up periodically. Adrenal carcinoma or functioning tumors will require surgery. Medical therapy for functioning tumors can be given as a bridge therapy till surgery.