Adrenal Tumours

Adrenal tumours are defined as abnormal growths that develop in the adrenal glands, which are small, triangular-shaped glands located on top of each kidney. These glands play a crucial role in producing hormones that regulate various bodily functions, including metabolism, immune response, and stress management. The presence of these tumours can disrupt the normal hormonal balance in the body, leading to a range of health issues.

Types:

• Benign (non-cancerous) tumours: These tumours do not spread to other parts of the body and are often less aggressive. They may cause symptoms primarily due to their size or hormone production but generally have a good prognosis.

• Malignant (cancerous) tumours: These are more serious and can invade surrounding tissues or metastasize to distant organs. Early detection and treatment are vital for improving outcomes in patients with malignant adrenal tumours.

• Functional (hormone-producing) tumours: These tumours actively produce hormones, which can lead to various endocrine disorders. For instance, they may cause conditions such as Cushing's syndrome or Conn's syndrome due to excess cortisol or aldosterone production, respectively.

• Non-functional tumours: These tumours do not produce hormones and may not cause symptoms unless they grow large enough to exert pressure on adjacent structures. They are often discovered incidentally during imaging studies conducted for other reasons.

  
  

Common Types:

1. Adrenal adenoma: A common benign tumour that often produces excess hormones, leading to symptoms related to hormonal imbalance. These tumours are usually small and may require monitoring or surgical removal if symptomatic.

2. Adrenal carcinoma: A rare but aggressive form of cancer that arises from the adrenal cortex. It often presents with advanced symptoms and has a poorer prognosis compared to benign tumours.

3. Pheochromocytoma: This is a type of tumour that originates from the adrenal medulla and secretes catecholamines, leading to episodes of high blood pressure, palpitations, and sweating. It can be sporadic or part of genetic syndromes.

4. Neuroblastoma (in children): This is a cancer that develops from immature nerve cells, primarily affecting children and often arising in the adrenal glands. It can present with a range of symptoms and has various treatment protocols depending on the stage of the disease.

   
   

Symptoms:

• High blood pressure: Often a result of excess hormone production, particularly in cases of pheochromocytoma or adrenal adenomas.

• Weight gain: Can occur due to hormonal imbalances, particularly in conditions like Cushing's syndrome, where cortisol levels are elevated.

• Excessive hair growth: Hirsutism may result from increased androgen levels produced by functional adrenal tumours.

• Changes in mood: Hormonal fluctuations can lead to mood swings, anxiety, or depression, impacting the patient's overall mental health.

• Abdominal pain: This may be due to the physical presence of the tumour or related complications, such as bleeding or pressure on surrounding organs.

  
  

Diagnosis:

• Imaging tests (CT scan, MRI): These are crucial for visualizing the adrenal glands and determining the size, shape, and location of the tumours. They help in differentiating between benign and malignant tumours based on characteristics observed in the images.

• Blood and urine tests for hormone levels: These tests are essential in assessing the functional status of the adrenal glands and identifying any hormonal excess or deficiency associated with the tumours.

• Biopsy (in some cases): A biopsy may be performed to obtain tissue samples for histological examination, particularly when there is suspicion of malignancy. However, this is not always necessary and is often avoided in cases where imaging findings are definitive.

  
  

Treatment:

1. Surgery to remove the tumour: Surgical intervention is often the primary treatment for both benign and malignant adrenal tumours, especially if they are causing symptoms or hormonal imbalances.

2. Medications to manage hormone levels: In cases where surgery is not an option or in the presence of functional tumours, medications may be prescribed to control hormone production and alleviate symptoms.

3. Radiation therapy (for malignant tumours): This may be utilized as an adjunct treatment for adrenal carcinoma or in cases where the tumour has spread, aiming to reduce the size of the tumour and manage symptoms.

   
   

Prognosis:

The prognosis for patients with adrenal tumours varies significantly based on several factors, including the type of tumour, its size, whether it is benign or malignant, and the overall health of the patient. Early detection and appropriate treatment can lead to favourable outcomes, particularly in cases of benign tumours and early-stage cancers.