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Adrenal Incidentaloma

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Posted by fatima.shakeel@opmc.co | Dec 31, 2024

What is an Adrenal Incidentaloma?

An adrenal incidentaloma refers to a mass found on the adrenal gland during imaging tests, such as CT scans or MRIs, that are performed for unrelated reasons. These masses are typically discovered accidentally and are not initially associated with adrenal issues.

What are the Adrenal Glands?

The adrenal glands are small, triangular glands located above the kidneys. They produce essential hormones, such as adrenaline, that regulate critical bodily functions. Although adrenal incidentalomas are often benign and harmless, further testing is needed to rule out malignancy (cancer) or hormone production.

Causes of Adrenal Incidentalomas

Most adrenal incidentalomas are benign (non-cancerous) and do not cause significant problems. However, in some cases, the mass may be malignant (cancerous) or a result of cancer that has metastasised (spread) from another part of the body. Common cancers that can spread to the adrenal glands include:

  • Lung cancer
  • Breast cancer
  • Kidney cancer
  • Melanoma (a type of skin cancer)

Signs and Symptoms

Most adrenal incidentalomas are asymptomatic, meaning they do not cause any symptoms. However, in cases where the tumour produces hormones or becomes malignant, symptoms can occur.

Signs of Hormone Overproduction

  • Unexplained weight gain
  • High blood pressure
  • Uncontrolled blood sugar levels
  • Excessive hair growth on the face, chin, and neck (in females)
  • Muscle weakness and bone thinning

Signs of Cancer

If the tumour becomes cancerous, the following symptoms may be present:

  • Unexplained weight loss
  • Persistent fatigue
  • Decline in overall health

Diagnosis

To diagnose adrenal incidentalomas and assess their nature, the following techniques are commonly used:

  1. Imaging Techniques: CT scans or MRIs are used to determine the size, location, and characteristics of the mass.
  2. Tumour Biopsy: A biopsy involves removing a small sample of the tumour to confirm whether it is benign or malignant.
  3. PET Scan: This advanced imaging technique helps detect cancer spread to other parts of the body.

Treatment Options

1. Monitoring

Small, non-cancerous tumours that do not produce hormones are monitored through periodic CT scans (every 6-12 months) to ensure they do not grow.

2. Surgery

Surgical removal of the adrenal gland is recommended if the tumour:

  • Is large or increasing in size
  • Produces hormones
  • Is suspected to be cancerous

3. Management of Disease Spread

If the adrenal incidentaloma is due to cancer that has spread from another organ, treatment focuses on addressing the primary cancer.

By regularly monitoring adrenal incidentalomas and intervening when necessary, complications can be minimised, and appropriate treatment can be provided.


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