Adrenal tumors, which are rare, can either increase hormone production (called functioning tumors) or do not produce hormones (called nonfunctioning). The vast majority (99%) of adrenal tumors are noncancerous adrenal cortical adenomas and do not require treatment. These tumors usually do not cause symptoms, are small, and are found incidentally during diagnostic imaging.
The most common type of adrenal cancer, called adrenocortical carcinoma, develops in the cortex. Functioning tumors of this type may produce symptoms related to increased hormone production. Nonfunctioning tumors may cause pain and can be felt when applying slight pressure to the abdomen with the fingers.
Cancers that develop in the medulla include neuroblastoma and pheochromocytoma. Neuroblastoma cancer usually occurs in infants and children, while pheochromocytoma cancer is more common in people in their 30s and 40s.
The adrenal glands are located on top of the kidneys and consist of two parts that function separately: the outer layer (cortex) and the inner area (medulla), both of which produce hormones. The cortex produces three major hormones: cortisol, aldosterone, and dehydroepiandrosterone (DHEA). The medulla produces epinephrine (adrenaline), norepinephrine, and dopamine.
Risk Factors for Adrenal Cancer
Worldwide, about 1 in 1 million people develop adrenal cancer annually. The incidence of adrenal cancer is slightly more frequent in men in their 40s and 50s and in children younger than 5 years old. In some cases, heredity can be a factor.
Adrenal Cancer Symptoms
Adrenal cancer does not always produce symptoms. Both nonfunctioning adrenocortical carcinomas and large functioning tumors may cause fever, persistent abdominal pain, a sensation of fullness, weight loss and can be felt by touch. Additional symptoms of functioning tumors depend on which hormones are overproduced.
Adrenal Cancer Diagnosis and Prognosis
Diagnosis of adrenal cancer may require blood and urine tests, imaging tests, and a biopsy. As with most cancers, the prognosis depends on the stage of the disease. Metastatic tumors have a poor prognosis. The five-year survival rate when surgical removal of the cancer is achieved is approximately 40%. About 80% of cases recur within 10 years after treatment.
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