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An adrenal tumor or adrenal mass [2] is any benign or malignant neoplasms of the adrenal gland, several of which are notable for their tendency to overproduce endocrine hormones. Adrenal cancer is the presence of malignant adrenal tumors, and includes neuroblastoma , adrenocortical carcinoma and some adrenal pheochromocytomas .
An adrenocortical adenoma or adrenal adenoma is commonly described as a benign neoplasm emerging from the cells that comprise the adrenal cortex. Like most adenomas , the adrenocortical adenoma is considered a benign tumor since the majority of them are non-functioning and asymptomatic .
Some of the patterns are distinct in adrenal hemorrhage while the other are undifferentiated from other adrenal abnormalities, such as adrenal neoplasm, adrenocortical carcinomas, and pheochromocytomas. [8] Hematomas have solid adrenal nodules, size of which are comparable to soft tissue and diminish over time.
An adrenal incidentaloma is a mass lesion larger than 1 cm in diameter that was unintentionally found through radiologic examination. [9] In patients who do not yet have a confirmed cancer diagnosis, adrenal incidentaloma is infrequently caused by malignancy.
Although adrenal incidentalomas are common, they are not commonly cancerous - less than 1% of all adrenal incidentalomas are malignant. [2] The first considerations are size and radiographic appearance of the mass. Suspicious adrenal masses or those ≥4 cm are recommended for complete removal by adrenalectomy.
MRI scan T1 with fat saturation - adrenal adenoma. Adrenal adenomas are common, and are often found on the abdomen, usually not as the focus of investigation; they are usually incidental findings. About one in 10,000 is malignant. Thus, a biopsy is rarely called for, especially if the lesion is homogeneous and smaller than 3 centimeters.
When an adrenal nodule (potential tumor) is discovered on computed tomography or magnetic resonance imaging, there is a 5–10% chance the lesion is a pheochromocytoma. [175] The incidence of adrenal tumors is found in the infographic above, with pheochromocytoma noted in yellow in the top right corner.
Rarely (5–12%), the adrenal tumor may be cancerous (adrenocortical carcinoma), requiring adrenalectomy. Rarer still, the mass may be a metastatic cancer that spread from another location, such as the kidney or lung. If the metastasis is isolated to the adrenal gland, it may be a candidate for adrenalectomy. [5] [7]