Adrenal Cancer

Overview

Adrenal cancer is a rare type of cancer that starts in the adrenal glands. These small glands sit on top of each kidney and produce hormones that help regulate important body functions, including blood pressure, metabolism, stress response and the balance of salt and water in the body.

The most common form is adrenocortical carcinoma, which begins in the outer part of the adrenal gland. Some adrenal tumors make excess hormones, while others do not produce hormones and may be found only when they grow large or are discovered during imaging for another reason.

Adrenal cancer can affect people of different ages, but it is uncommon. Because symptoms may be vague or related to hormone changes, diagnosis often requires evaluation by specialists such as endocrinologists, oncologists, radiologists and surgeons. Early assessment is important when an adrenal mass or unexplained hormone-related symptoms are present.

Symptoms

Symptoms of adrenal cancer vary depending on whether the tumor produces hormones and how large it becomes. Some people may have no symptoms at first.

If the tumor produces excess hormones, symptoms may include:

• Unexplained weight gain, especially around the face, neck or abdomen
• Easy bruising, skin thinning or stretch marks
• Muscle weakness or fatigue
• High blood pressure
• High blood sugar or new problems with blood sugar control
• Irregular menstrual periods
• Increased facial or body hair growth in women
• Deepening of the voice or other changes related to excess male-type hormones
• Breast enlargement or reduced sexual function in men

If the tumor grows large, it may cause symptoms due to pressure on nearby organs, such as:

• Abdominal or back pain
• A feeling of fullness or bloating
• Unexplained weight loss
• Nausea or reduced appetite

These symptoms can be caused by many conditions other than adrenal cancer. A medical evaluation is needed to understand the cause.

Causes and Risk Factors

In many people, the exact cause of adrenal cancer is not known. Cancer develops when cells acquire changes that allow them to grow and divide in an uncontrolled way. These changes may occur by chance or, less commonly, be related to inherited genetic conditions.

Risk factors that may be associated with adrenal cancer include:

• A family history of certain rare inherited cancer syndromes
• Previous diagnosis of genetic conditions that increase the risk of adrenal tumors
• A personal history of certain childhood or hereditary cancers
• Age, as adrenal cancer can occur in both children and adults, with patterns that vary by tumor type

Most adrenal nodules are not cancerous. However, any adrenal mass that is large, growing, has suspicious imaging features or produces excess hormones should be evaluated carefully by a medical team.

Diagnosis

Diagnosis usually begins with a detailed medical history and physical examination. The doctor may ask about symptoms related to hormone changes, blood pressure, weight changes, family history and previous imaging results.

Tests may include blood and urine tests to measure hormone levels produced by the adrenal glands. These tests help determine whether the tumor is “functioning,” meaning it is making excess hormones.

Imaging tests are also important. A computed tomography scan or magnetic resonance imaging scan may be used to assess the size, shape and appearance of the adrenal mass and to look for possible spread to nearby structures or other parts of the body. Additional imaging may be recommended in some cases.

A biopsy is not always performed for adrenal tumors and may not be appropriate in certain situations. In some cases, doctors first need to rule out specific hormone-producing tumors because biopsy could carry risks. The decision depends on imaging findings, hormone test results and the overall treatment plan.

After diagnosis, staging may be performed to understand how far the cancer has developed. Staging helps guide treatment decisions and allows the care team to plan the most suitable approach.

Treatment Options

Treatment for adrenal cancer depends on several factors, including the size and stage of the tumor, whether it produces hormones, whether it has spread, and the patient’s overall health. Care is often coordinated by a multidisciplinary team.

Surgery is commonly considered when the tumor can be removed. The goal is to remove the adrenal tumor completely, and sometimes nearby tissues or lymph nodes may also need to be removed depending on the findings. Surgical planning is individualized and may involve open or minimally invasive techniques in selected cases.

Additional treatments may be recommended after surgery or when surgery is not possible. These can include systemic cancer treatments, radiation therapy or other approaches aimed at controlling tumor growth or managing symptoms. Treatment may also include medical management of hormone excess, blood pressure or metabolic problems caused by the tumor.

Follow-up care is an important part of management. Regular visits, hormone testing and imaging may be used to monitor for recurrence, assess treatment response and manage long-term effects. The schedule and type of follow-up depend on the individual situation.

Because adrenal cancer is rare, evaluation in a center experienced with complex endocrine and oncology conditions can help ensure that diagnosis and treatment planning are carefully coordinated.

When to See a Doctor

Seek medical advice if you have persistent or unexplained symptoms such as abdominal or back pain, significant changes in weight, unusual bruising, new or difficult-to-control high blood pressure, changes in menstrual cycles, or signs of excess hormone production.

You should also consult a doctor if an adrenal mass is found during imaging for another reason. Even when adrenal nodules are benign, they may need testing to check hormone activity and imaging features.

Urgent medical attention may be needed for severe abdominal pain, sudden weakness, confusion, very high blood pressure symptoms, or rapid worsening of general condition. A healthcare professional can assess symptoms, arrange appropriate tests and guide you to the right specialist if needed.