Endocrine Surgery

Incidentally Discovered Adrenal Masses

• I had a CT scan for an unrelated reason and it showed I have a mass on one of my adrenal glands. What should I do?
  • Most incidentally discovered, small adrenal masses are benign.
  • However, appropriate workup (see below) is very important and should be evaluated by an endocrinologist and/or and endocrine surgeon.
    
    
• What is the workup?
  • Workup includes a series of blood tests, sometimes urine tests, and imaging. There is no role for needle biopsy unless a tumor is strongly felt to be a metastatic lesion from another cancer.
    
    
• Do I need surgery?
  • Surgery is generally reserved for tumors that are making hormones (determined by your lab tests), growing in size over time, larger (> 3-4cm), or have very suspicious radiologic characteristics.
    
    
• What are the different types of adrenal tumors?
  • Functional tumors can produce one of the following hormones:
    • Aldosterone (Conn’s syndrome)
    • Cortisol (Cushing’s syndrome)
    • Catecholamines (Pheochromocytoma)   
    • Testosterone (very rare)
  • Other benign adrenal masses
  • Non-functional tumors
  • Malignant tumors
    • Adrenal cortical cancer
    • Adrenal metastases from other cancers

Please refer to the American Association of Endocrine Surgeons patient education website for more detailed information: http://endocrinediseases.org/adrenal/index.shtml