Additional Tumor Conditions

Benign adrenal masses

Adrenal cysts and pseudocysts

There are generally benign tumors. However, the can grow very big and sometimes cause non-specific symptoms such as pain and compression or other organs.

Indications for removal are symptoms (where a very large adrenal tumor is the most likely cause) or increasing size of the mass.

Adrenal metastases from other cancers

Q: What are the most common cancers that metastasize to the adrenal gland?

  • The most common cancers are lung, breast, kidney, gastrointestinal, melanoma and lymphoma.

Q: How is it diagnosed?

  • Adrenal metastases are generally found on imaging (CT, MRI, PET scan) that is part of routine cancer follow-up after treatment for other cancers.
  • Diagnosis is usually made by a CT-guided biopsy performed by the radiologist after appropriate blood tests have been drawn to make sure the adrenal mass is not producing any hormones.

Q: What are the indications to surgically remove the metastasis?

  • This will be decided on an individual basis with your oncologist and surgeon.
  • If the adrenal metastasis is the only known metastases, and your cancer is otherwise stable and under good control without other disease, then you may be a candidate for surgical removal of your adrenal tumor.

Q: Can this surgery be done through the laparoscope (camera)?

If possible (the tumor is confined to the adrenal gland and not adherent or invading other structures) the surgery is done laparoscopically.

Adrenal cortical cancer (ACC)

Q: What are risk factors for adrenal cancer?

  • The majority of ACCs are sporadic and without risk factors.
  • There are two rare genetic syndromes that are associated with ACC: Li-Fraumeni and Beckwith-Wiedemann Syndromes.

Q: How is it diagnosed?

  • Definitive diagnosis is only made on final pathology. However, certain characteristics of the tumor on imaging studies make it highly suspicious for ACC.

Q: What is the treatment?

  • If surgically resectable: open adrenalectomy and en-bloc removal of the tumor, the surrounding tissues, any invading structures and the regional lymph nodes.
    • Adjuvant therapy with mitotane and possibly chemotherapy is usually recommended.
  • Unresectable tumors: mitotane, chemotherapy and clinical trials with newer biologic agents.

Q: Is adrenal cancer serious? What is the prognosis?

  • Adult adrenal cortical cancer is an aggressive tumor that is not usually found until it has advanced to a later stage and therefore has a poor prognosis.
  • Prognosis for smaller tumors that are confined to the adrenal gland and removed early can have a five-year survival of up to 65 percent.

Q: Can my cancer come back?

  • Since ACC is an aggressive tumor, it can come back either locally (in the same location) or in a distant location as metastatic disease.

Q: Are there risk factors for recurrence?

  • Completeness of surgical resection, size, stage at diagnosis, and tumor biology are the most important factors for recurrence.

Q: How is my cancer monitored after surgery?

  • You will have lifelong follow-up with an oncologist, surgeon, and endocrinologist.
  • Monitoring will consist of periodic imaging and blood tests to monitor for recurrence and/or disease progression.