Introduction:
An abnormal growth in the adrenal gland is called an adrenal mass. There is no clarity regarding its origin; it is diagnosed by chance during scans for other issues. Most of these growths are noncancerous (benign), and those smaller in size do not require surgery. Adrenal glands measure 0.5 inches in height and 3 inches in length, are triangular, and are located above the kidneys. The adrenal gland’s inner part (adrenal medulla) secretes adrenaline (epinephrine). The outer section (adrenal cortex) makes steroids (cortisone, aldosterone). The adrenal gland controls many body processes and keeps its balance by secreting various hormones.
How Do Adrenal Glands Work?
Epinephrine and norepinephrine secreted by the inner part of the adrenal medulla manage the body’s reaction to stress affecting heart rate, blood pressure, and sweating. Cortisol and aldosterone help the body break down blood sugars and react to stress and change. These hormones secreted by the cortex control blood pressure, metabolism, salt and potassium level, and sex hormones.
What Happens if the Adrenal Gland Has a Problem Inside?
The problem inside the gland may be due to a disease or mass. However, adrenal disorders can occur from outside the gland also. The hypothalamus and pituitary glands may fail to produce hormones that control the adrenal glands.
What Are the Health Issues Caused by Adrenal Disorders?
The health issues caused by adrenal disorders are:
Adrenal Gland Cancer: Rare cancer affects one to three million per year.
Conn Syndrome (Hyperaldosteronism): Rare health problem caused due to increased aldosterone secretion known as primary hyperaldosteronism.
Cushing Syndrome (CS): Rare problem caused due to increased secretion of cortisol. CS is often due to a tumor or mass seen in the pituitary gland. In addition, noncancerous adrenal tumors can cause CS.
Pheochromocytoma: Tumor found in the adrenal medulla.
What Are the Types of Adrenal Masses?
The different types of adrenal masses are:
Non-functional Benign Tumors and Cysts: They do not produce hormones.
Functional Tumors: They produce hormones like aldosterone, cortisol, catecholamines, and testosterone very rarely.
Malignant Tumors: Adrenal cortical cancer and adrenal metastases are examples.
What Are Non-functional Adrenal Masses?
Tumors or masses in the adrenal gland that do not secrete hormones. One in 20 adults and one in 10 adults over 70 tend to have this disease.
What Is the Cause of Non-functional Adrenal Masses?
They have an unknown cause. Few cases have been found to have a genetic link. The masses are very rare among children. The chances of developing the disease increase with age.
What Are the Most Common Nonfunctional Adrenal Masses in Adults?
Most common are adrenal adenomas (50 percent), while others are carcinomas and metastatic tumors. The remaining are cysts and lipomas. The incidence is less common in neonates; spontaneous adrenal hemorrhage may cause large adrenal masses, pretending neuroblastoma or Wilms tumor. In adults, bilateral massive adrenal hemorrhage may result from thromboembolic disease or coagulopathy, whether disease or drug-related.
Benign cysts are observed in older patients due to cystic degeneration or vascular accidents. Lymphomas, bacterial infections, fungal infections, or parasitic infections may manifest with adrenal masses. A non-functional adrenal carcinoma causes diffuse and infiltrating retroperitoneal processes. Hemorrhage (bleeding) is possible, causing an adrenal hematoma.
What Are the Conditions That Affect the Risk of Non-functional Adrenal Masses?
Certain genetic conditions which increase the risk are:
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Multiple Endocrine Neoplasias, Type 1 (MEN1): Also called Wermer’s syndrome, are rare disease-causing tumors of the endocrine glands and parts of the small intestine and stomach.
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Familial Adenomatous Polyposis (FAP): An inherited condition that affects the gastrointestinal tract.
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Carney Complex: A hereditary condition related to spotty skin pigmentation, myxomas like benign tumors.
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Li-Fraumeni Syndrome: A rare hereditary disease with a risk of getting cancer.
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Multiple Endocrine Neoplasia Type2 (MEN2): A hereditary disease related to three types of tumors involving medullary, thyroid cancer, and parathyroid tumors.
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Neurofibromatosis Type 1: A genetic condition that causes tumors to grow in nerves.
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Obesity and Tobacco Use: Increased weight and tobacco use increase the risk of non-functional adrenal masses.
What Are the Symptoms of Non-functional Adrenal Masses?
It does not cause symptoms unless it is large and pressing on other organs.
Signs of massive bilateral hemorrhage are:
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Abdominal pain.
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Falling hematocrit.
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Loss of consciousness.
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Fatigue and dehydration.
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Suprarenal masses.
How Are Non-functional Adrenal Tumors Diagnosed?
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Detected when scans are done for other reasons.
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Radiologists watch out for changes like size, shape, and other mass characteristics to decide whether it is benign or malignant.
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Blood tests are done to know changes in hormone levels indicating the tumor is secreting hormones.
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Computed Tomography (CT): CT is an imaging technique that uses special X-ray equipment to take pictures or scans of the body.
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Magnetic Resonance Imaging (MRI): An imaging technique that uses a magnetic field and computer-generated radio waves to know the details of organs and tissues in the body.
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Biopsy: A procedure to remove a piece of tissue or a sample of cells from the human body and send it for laboratory testing.
What Is the Treatment of Non-functional Adrenal Masses?
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Adrenal mass with no signs of hormone production may not need any treatment. Periodic monitoring is required.
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The adrenal mass shows symptoms like abdominal pain and a decrease in the adrenal hormone level due to the tumor pressing against the gland. In these cases, surgery is needed to remove the adrenal gland to give relief.
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One adrenal gland can do the work effectively if the other adrenal gland is removed.
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Small non-functional adrenal tumors do not require surgery.
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Non-functional adrenal carcinoma with metastasis should not be treated with surgery.
Can Nonfunctional Adrenal Mass Be Prevented?
No. It is genetically linked and hence cannot be prevented. There are chances of getting this disease, even with no family history.
What Is the Prognosis of Nonfunctional Adrenal Mass?
The prognosis of nonfunctional adrenal mass is excellent after adrenalectomy (removal of the gland).
How Can One Take Care of Non-functional Adrenal Masses?
One should follow the healthcare provider’s instructions about periodic tests.
Conclusion:
Non-functional adrenal masses are not harmful. They do not produce hormones and do not change the body’s processes. Therefore, one should not panic about its detection. Following a healthcare provider’s instructions, a person can lead a near-normal life. Regular physician follow-up visits are necessary to take care of non-functional adrenal masses.
