Adrenal Gland Tumors - Early Signs, Risk Factors, Diagnosis, and Treatment Explained

Overview: What Are Adrenal Gland Tumors?

The adrenal glands are two small organs that sit on top of the kidneys. Despite their size, they play a major role in controlling hormones that regulate blood pressure, metabolism, stress response, and other essential body functions. An adrenal gland tumor is an abnormal growth in one or both adrenal glands. Adrenal gland tumors may be non-cancerous (benign) or cancerous (malignant). Most are found by chance on scans for other reasons. The aggressive form, called adrenocortical carcinoma, is very rare but needs urgent treatment.

Adrenal gland tumors are considered rare. Malignant adrenal tumors, known as adrenocortical carcinoma, occur in about 1–2 people per million each year. Because these tumors may not cause obvious symptoms in the early stages, they are often discovered late. Early detection matters because treatment is far more effective when the tumor is small and localized.

What Are the Types of Adrenal Gland Tumors?

There are several types of adrenal tumors, depending on whether they are cancerous and the kind of hormones they affect.

• Adrenocortical carcinoma (ACC): A rare but aggressive cancer that starts in the outer layer (cortex) of the adrenal gland.
• Adenoma: A benign tumor of the adrenal cortex. Often found incidentally during scans done for other reasons.
• Pheochromocytoma: A usually benign tumor that arises from the adrenal medulla (inner part). It produces excess adrenaline, leading to high blood pressure and other symptoms.
• Neuroblastoma: A childhood cancer that can develop in the adrenal medulla.
• Metastatic tumors: Cancers that spread to the adrenal glands from other organs, such as the lungs or breast.

What Are the Causes of Adrenal Gland Tumors?

The exact causes of adrenal gland tumors are not fully understood. However, several factors may play a role:

• Genetic mutations: Changes in certain genes can cause abnormal cell growth.
• Hormonal imbalances: Overproduction of hormones may contribute to tumor growth.
• Inherited syndromes: Conditions like Li-Fraumeni syndrome, Beckwith-Wiedemann syndrome, and multiple endocrine neoplasia increase the risk.
• Family history: Having close relatives with adrenal or related cancers may raise the likelihood.

What Are the Risk Factors for Adrenal Gland Tumors?

Not everyone with risk factors develops adrenal tumors, but these factors may increase the chances:

• Genetics: Inherited syndromes or family history of adrenal tumors.
• Age: Adrenocortical carcinoma is more common in children under 5 and adults in their 40s–50s.
• Gender: Some studies show women may be at slightly higher risk.
• Lifestyle factors: Unlike lung or breast cancer, lifestyle causes are less clear for adrenal tumors. However, good overall health helps reduce risks.
• Other cancers: Having certain cancers increases the risk of adrenal metastases.

What Are the Symptoms of Adrenal Gland Tumors?

Symptoms depend on whether the tumor is functional (producing hormones) or non-functional (not producing hormones).

Common early signs include:

• Unexplained weight gain or loss
• Fatigue and weakness
• High blood pressure
• Anxiety, sweating, or palpitations

Advanced or hormone-related symptoms may include:

• Excess hair growth (especially in women)
• Deepening of the voice in women
• Irregular menstrual cycles
• Muscle cramps or weakness
• Easy bruising or stretch marks on the skin
• Diabetes or worsening blood sugar control

Because symptoms can mimic common conditions like high blood pressure or diabetes, adrenal tumors may go unnoticed until they grow larger.

How Are Adrenal Gland Tumors Diagnosed?

Diagnosing adrenal gland tumors usually involves multiple steps:

• CT Scan: CT is often the first-choice imaging test to detect adrenal tumors, evaluate their size and characteristics, and determine if they have spread.
• MRI Scan: An MRI provides detailed images of the adrenal glands and surrounding structures, which can be helpful for further evaluation.
• MIBG (metaiodobenzylguanidine) Scan: This specialized nuclear medicine scan can detect neuroendocrine tumors and is useful for diagnosing tumors that may not show up clearly on other scans.
• Hormone Level Tests: Blood and urine tests measure levels of adrenal hormones like cortisol, aldosterone, and catecholamines (like epinephrine and norepinephrine) to identify "functional" tumors that are overproducing hormones.
• Adrenal Vein Sampling: An interventional radiologist takes blood samples from the veins of each adrenal gland to identify which gland contains the tumor or to confirm if both glands have tumors.

Staging of Adrenal Gland Tumors

Once diagnosed, doctors determine the stage (how far the cancer has spread) and grade (how abnormal the cells look).

• Stage I: Tumor is smaller than 5 cm and confined to the adrenal gland.
• Stage II: Tumor is larger than 5 cm but still localized.
• Stage III: Tumor has spread to nearby lymph nodes or tissues.
• Stage IV: Tumor has spread (metastasized) to distant organs.

Staging helps doctors plan the best treatment and predict outcomes.

What Are the Treatment Options for Adrenal Gland Tumors?

Treatment depends on the type, size, stage, and whether the tumor is producing hormones.

• Surgery: Surgical removal of the affected adrenal gland, adrenalectomy, is the main treatment for most adrenal tumors, especially adrenocortical carcinoma and pheochromocytomas. Minimally invasive (laparoscopic) surgery may be possible for smaller tumors. In some cases, nearby lymph nodes may also be removed if there's concern the tumor has spread.
• Medical Treatment: Chemotherapy is often used for treatment of advanced or metastatic adrenal cancers, like malignant adrenocortical carcinoma. Targeted therapy involves drugs that target specific genetic mutations in cancer cells, attacking them more selectively than chemotherapy. Hormone therapy is used in cases where the tumor produces excess hormones. Medicines may be used to block hormone effects.
• Radiation Therapy: Radiation may be used to control pain or shrink tumors that cannot be surgically removed.

Proton Therapy: When Is It Applicable?

Available at Apollo Proton Cancer Centre, proton therapy uses protons instead of X-rays to deliver radiation more precisely to cancer cells. The advantage is that protons can be controlled to release their energy directly into the tumor with minimal exit dose, sparing healthy tissue.

Advanced proton beam therapy can be used in select adrenal gland cancers. This advanced radiation technique is considered for locally advanced tumors, recurrent cancers, tumors in hard-to-reach areas, and for symptom relief.

What Is the Prognosis for Adrenal Gland Tumors?

The outlook depends on the type and stage of the tumor.

• Benign tumors (adenomas, most pheochromocytomas): Excellent prognosis after surgery.
• Adrenocortical carcinoma: The 5-year survival rate ranges from about 50–60% for early-stage disease to less than 20% for advanced stages.

Prognosis is also influenced by age, tumor size, response to treatment, and whether the cancer has spread. Early detection greatly improves survival chances. Many adrenal tumors are curable with surgery. Even in advanced cases, treatments can help control symptoms and improve quality of life.

Screening and Prevention of Adrenal Gland Tumors

Currently, there are no routine screening tests for adrenal cancer in the general population. However, people with strong family histories or genetic syndromes may need regular monitoring.

Prevention strategies include:

• Regular health checks if you have risk factors
• Managing blood pressure, weight, and diabetes
• Avoiding smoking and limiting alcohol

For International Patients

People from around the world come to Apollo Hospitals for the treatment of adrenal gland tumors. Our international patient services team will guide you all the way from seeking the first virtual connect all the way to treatment in India and then returning home post treatment.

Services include:

• Medical opinions and scheduling
  • Pre-arrival medical review of reports and imaging.
• Travel and logistics
  • Assistance with visa invitation letters, airport transfers, and nearby accommodation options.
  • Dedicated international patient coordinators to guide through each step.
• Language and cultural support
  • Interpreter services in multiple languages.
  • Clear, simple explanations at every stage with written care plans.
• Financial coordination
  • Transparent treatment estimates and packages when possible.
  • Support with international payment methods and insurance coordination.
• Continuity of care
  • Shared records, imaging, and treatment summaries for home doctors.
  • Telemedicine follow-ups for convenience after returning home.

Frequently Asked Questions (FAQs)

1. What is the survival rate for adrenal gland cancer?

The survival rate depends on the stage. For early-stage adrenocortical carcinoma, the 5-year survival can be around 50–60%. For advanced cases, it is lower. Benign adrenal tumors usually have excellent outcomes.

2. What are the treatment side effects?

Side effects depend on the therapy. Surgery may cause pain or fatigue during recovery. Chemotherapy can cause nausea, hair loss, and low immunity. Radiation may cause skin irritation or tiredness.

3. Can adrenal tumors come back after treatment?

Yes, recurrence is possible, especially in adrenocortical carcinoma. Regular follow-ups with scans and blood tests are important.

4. How long is the recovery time after adrenal surgery?

Most patients recover in 2–6 weeks, depending on whether surgery was laparoscopic or open.

5. Can adrenal gland tumors be cured?

Benign tumors can often be completely cured with surgery. Malignant tumors may be cured if detected early and removed completely. Advanced cases are harder to cure but treatments can control symptoms and improve survival.

6. What is the cost of adrenal gland tumor treatment in India?

Costs vary depending on the hospital, type of surgery, and treatment needed. At Apollo, costs are significantly lower compared to the US or Europe, while maintaining international standards. International patients can get package estimates before travel.