There are two adrenal glands each one situated above the upper poles of kidneys. The adult adrenal gland weighs 3 to 5 grams. Adrenal adenomas are non cancerous tumors of adrenal gland. This tiny gland is very important for the body as it produces vital steroid hormones.
Adrenal gland is made up of two different parts, the cortex and medulla. The outer part is cortex while the inner part is medulla.Cortex produces cortisone and aldosterone hormones. Inner medulla produces adrenaline and nor-adrenaline hormone.
Adrenal adenoma grows from the outer cortex. When the adenoma itself produces hormones, it is called functioning while non functioning adenoma does not produce hormones independently. Adrenal adenoma usually is not harmful, unless it starts producing hormones. Functioning adrenal adenoma can lead to rise in hormones leading to various complicated conditions.
Signs And Symptoms Of Adrenal Adenoma
Majority of patients having adrenal adenoma remain symptom less. But some patients exhibit symptoms where the adrenal adenoma is functioning. It means there is additional amount of hormone production besides that secreted from the adrenal gland. Excess amount of adrenal hormone cortisone can cause conditions such as Cushing syndrome. Excess of aldosterone hormone can cause Conn’s syndrome.
Aldosterone and androgen are sex hormones which in excess produces excess growth of hair on chin, between the breast, and on the face in females. In rare cases bleeding can occur from the adenoma giving rise to back pain and pain in the flanks. Below are given symptoms of adrenal adenoma:
Symptoms of Cushing syndrome:
The typical patient with this syndrome is middle aged with truncal obesity and hypertension. Obesity is truncal sparing the limbs.
- Neck is thick and short with excess of fat over the upper back appearing like a ‘buffalo hump’.
- Fatigue and Muscle weakness.
- Weak bones leading to sudden fractures.
- Low back pain is common feature due to weak spinal bones.
- Kidney stones
- Young patients may have growth retardation.
- Unwanted hair growth on face and chest, in females.
- Emotional changes ranging from irritability to depression.
- Loss of scalp hair.
- Delayed wound healing with easy bruising.
- Menstrual irregularity
- Large sized clitoris with increases sexual urge in females.
- Females with hoarse and deep voice.
Conn’s syndrome symptoms:
- Commonly seen in females between the ages of 30 to 50 years.
- Cardiac arrhythmias
- Increased urination
- Low potassium level
- Intolerance to sugar and carbohydrates.
Causes Of Adrenal Adenoma
The exact cause of adrenal adenoma remains obscure. Scientists are unable to pinpoint the reason for this growth. However, they believe the reason for adrenal adenoma is mutation in certain genes. But they are unable to identify the specific gene.
Patients suffering from certain inherited diseases such as multiple endocrine neoplasia, B-W syndrome are found with adrenal adenomas during examination and radiological investigations. Adrenal adenomas occur in all age groups, but their incidence rises with growing age. They are equally present in males as well as females.
Treatment Of Adrenal Adenoma
Treatment of adrenal adenoma depends whether the tumor is functional or non functional. Meaning the tumor is hormone releasing or not releasing hormones. Patients with functional tumor require surgical removal of the affected adrenal gland. This will help in reducing the secretion of excess of adrenal hormones resolving conditions such as Cushing’s syndrome and Conn’s syndrome. In some cases medications can be useful in blocking excess secretion of hormones from the adenomas.
Non functional adenoma needs regular monitoring and can be treated conservatively. Regular follow up with the treating physician will help to monitor its size or whether it has started producing hormones.