Benign Adrenal Tumors

Diagnosis

Benign adrenal tumors are typically found by chance on imaging tests. Once detected, a healthcare professional evaluates:

• Cancer risk: Determining whether the tumor has characteristics that suggest malignancy.

• Hormone production: Checking if the tumor secretes excess hormones, which can affect blood pressure, metabolism, and other bodily functions.

Diagnostic tests may include:

• Blood and urine tests: Assess for excess hormones and identify the specific hormone being produced.

• Imaging studies: Provide detailed information about the tumor’s size, location, and cancer risk.

Imaging options include:

• CT scan: Produces cross-sectional X-ray images for detailed visualization of the adrenal gland.

• MRI: Uses radio waves and magnetic fields to generate high-resolution images.

• M-iodobenzylguanidine (MIBG) scan: A radioactive compound highlights tumors that take up the substance, identifying even small growths.

• Positron emission tomography (PET): Detects tumors that absorb radioactive compounds.

• Ga-DOTATATE PET scanning: Advanced imaging, often combined with CT or MRI, for identifying endocrine system tumors; availability may be limited.

Treatment

Many benign adrenal tumors do not require immediate treatment. Decisions are based on:

• Hormone production

• Tumor growth or symptoms

• Risk of malignancy

Management strategies include:

• Active surveillance (watchful waiting):

  • Small, non-hormone-producing tumors may be monitored with repeat imaging at 3–6 months after diagnosis, then every 1–2 years.

  • Hormone levels may be checked annually for up to 5 years.

• Medication management:

  • For tumors causing hormone-related symptoms, medications may help control conditions like high blood pressure before surgery.

• Surgery (adrenalectomy):

  • Removal of the adrenal gland may be necessary if the tumor grows, causes symptoms, or has a higher risk of cancer.

  • Laparoscopic surgery is often used for small, low-risk tumors.