Adrenal Gland Tumor: Symptoms, Causes, Treatment

What Is an Adrenal Gland Tumor?

An adrenal gland tumor is an abnormal growth in one of the adrenal glands. These tumors may arise in the outer layer of the gland, called the adrenal cortex, or in the inner portion, called the adrenal medulla.

The adrenal cortex produces hormones such as cortisol, aldosterone, and adrenal androgens. The medulla produces epinephrine and norepinephrine, often called adrenaline-related hormones. Because these hormones affect major body functions, even a small tumor can sometimes cause noticeable symptoms.

Functional vs. Nonfunctional Adrenal Tumors

Doctors often classify adrenal tumors according to whether they make extra hormones. A functional adrenal tumor produces excess hormones and may cause high blood pressure, low potassium, unexplained weight changes, unusual sweating, anxiety-like episodes, or changes in body hair and skin.

A nonfunctional adrenal tumor does not make extra hormones. These masses may cause no symptoms at all and are often discovered incidentally during imaging for back pain, kidney stones, digestive symptoms, or another unrelated concern. These surprise findings are sometimes called adrenal incidentalomasmedical shorthand for “Well, nobody expected to find that.”

Common Types of Adrenal Tumors

Adrenal Adenoma

An adrenal adenoma is a common benign tumor that develops in the adrenal cortex. Many adenomas are small, nonfunctional, and harmless. However, some release too much cortisol or aldosterone and can require treatment.

Pheochromocytoma

A pheochromocytoma is a tumor that develops in the adrenal medulla. It can produce excess catecholamines, including epinephrine and norepinephrine. These hormones can trigger episodes of severe high blood pressure, pounding heartbeat, sweating, headache, shaking, and a sudden feeling of fear or panic.

Adrenal Myelolipoma

An adrenal myelolipoma is usually a benign growth made largely of fat and bone marrow-like tissue. Many are found by accident and monitored over time. Larger myelolipomas can occasionally cause pressure, discomfort, or bleeding risk, which may lead a care team to recommend surgery.

Adrenocortical Carcinoma

Adrenocortical carcinoma, often called adrenal cancer, is rare but can be aggressive. It begins in the adrenal cortex and may produce excess cortisol, aldosterone, estrogen, testosterone, or other hormones. Some tumors do not make hormones and may only become noticeable when they grow large enough to cause pain, fullness, or pressure in the abdomen.

Adrenal Gland Tumor Symptoms

Symptoms depend on the tumor’s size, location, hormone activity, and whether it is pressing on nearby tissues. A small benign nonfunctional mass may cause no symptoms at all. A hormone-producing tumor, on the other hand, can behave like a tiny factory working overtime with no manager in sight.

Symptoms of Excess Cortisol

Tumors that make too much cortisol can lead to signs associated with Cushing syndrome. Symptoms may include:

• Weight gain that is difficult to explain, especially around the abdomen and upper body
• Rounding of the face or increased fullness around the neck
• Muscle weakness, particularly in the hips or shoulders
• Easy bruising or slow healing
• Wide purple or reddish stretch marks
• High blood pressure or high blood sugar
• Mood changes, sleep problems, fatigue, or trouble concentrating
• Irregular menstrual cycles or changes in sexual function

Symptoms of Excess Aldosterone

Aldosterone helps regulate salt, fluid, and potassium levels. When an adrenal tumor produces too much aldosterone, it may cause primary aldosteronism. Possible symptoms include:

• High blood pressure that is difficult to control
• Low potassium levels
• Muscle cramps, weakness, tingling, or spasms
• Headaches and fatigue
• Frequent urination or increased thirst

Symptoms of a Pheochromocytoma

Pheochromocytoma symptoms can come and go in episodes. Common warning signs include:

• Sudden or severe high blood pressure
• Intense headaches
• Heavy sweating without an obvious reason
• Rapid heartbeat, palpitations, or chest pounding
• Trembling, shakiness, or pale skin
• Strong anxiety or panic-like feelings
• Nausea, abdominal pain, or unexplained weight loss

These symptoms can resemble panic attacks, thyroid disease, medication effects, heart rhythm problems, or ordinary stress. That overlap is one reason diagnosis can take time.

Symptoms Related to Sex Hormones

Some adrenal tumors make extra androgens or estrogens. Possible changes include new or rapidly increasing body hair, acne, deepening of the voice, menstrual changes, breast tenderness, reduced libido, or other unexpected changes in sexual or reproductive health.

Symptoms Caused by Tumor Size or Pressure

Larger adrenal masses can cause symptoms even if they do not make hormones. These may include persistent abdominal pain, back or flank pain, a feeling of fullness, reduced appetite, nausea, or unintentional weight loss.

What Causes Adrenal Tumors?

In many cases, doctors cannot identify one clear cause. Most adrenal tumors are sporadic, meaning they arise from changes in cells over time rather than from something a person did or did not do. There is no reliable evidence that everyday stress alone creates an adrenal tumor, despite the adrenal glands’ close relationship with the body’s stress response.

Some tumors are linked to inherited genetic conditions. A doctor may recommend genetic counseling or testing when a person is young at diagnosis, has tumors in both adrenal glands, has a family history of related tumors, or has features suggesting an inherited syndrome.

Genetic conditions associated with a higher risk of certain adrenal tumors include:

• Multiple endocrine neoplasia type 2
• Von Hippel-Lindau disease
• Neurofibromatosis type 1
• Li-Fraumeni syndrome
• Beckwith-Wiedemann syndrome

Having one of these conditions does not guarantee an adrenal tumor will develop. It simply gives doctors a reason to monitor more closely and consider screening when appropriate.

How Doctors Diagnose an Adrenal Gland Tumor

Diagnosing an adrenal mass usually involves three questions: Is it making hormones? Does imaging suggest it is benign or concerning? Has it spread or affected nearby structures?

Medical History and Physical Exam

A clinician may ask about blood pressure trends, headaches, sweating episodes, weight changes, menstrual history, sleep, medications, family history, and symptoms of hormone excess. They may also review whether you use steroid medicines, because steroids can affect cortisol testing and mimic some adrenal-related symptoms.

Blood and Urine Testing

Hormone tests may include cortisol testing, dexamethasone suppression testing, aldosterone and renin levels, blood potassium, plasma metanephrines, or 24-hour urine studies. The exact tests depend on the symptoms and imaging findings.

For example, a person with difficult-to-control high blood pressure and low potassium may be evaluated for excess aldosterone. Someone with sweating spells, severe headaches, and a racing heartbeat may be tested for catecholamine excess and pheochromocytoma.

Imaging Tests

CT scans and MRI scans help doctors evaluate the tumor’s size, density, shape, and location. In some cases, PET scans or specialized nuclear medicine scans are used to look for cancer spread or identify certain neuroendocrine tumors.

Adrenal Vein Sampling and Biopsy

Adrenal vein sampling may be used in selected cases of primary aldosteronism to determine whether one adrenal gland or both glands are producing excess aldosterone. This helps guide treatment decisions.

A biopsy is not routinely the first step for an adrenal mass. Doctors usually rely on hormone testing and imaging first. In particular, a pheochromocytoma should be evaluated before a biopsy is considered because disturbing a catecholamine-producing tumor can cause dangerous blood pressure changes.

Adrenal Gland Tumor Treatment Options

Treatment depends on the tumor type, size, hormone activity, imaging appearance, symptoms, and whether cancer is suspected. There is no single “best” treatment for every adrenal mass. One person may need periodic scans; another may need surgery and hormone management.

Active Surveillance

Small, nonfunctional tumors with benign imaging features may not need immediate treatment. A healthcare team may recommend follow-up imaging, repeat hormone testing, blood pressure monitoring, or periodic lab work. This approach is not “doing nothing.” It is structured observation with a plan.

Medication

Medicines may help control hormone-related effects. For example, treatment may be used to manage high blood pressure, correct potassium problems, reduce cortisol effects, or control symptoms caused by catecholamine excess.

People with pheochromocytoma usually need carefully planned medication before surgery to reduce the risk of dangerous blood pressure surges during the operation. This preparation is highly individualized and should be managed by specialists familiar with adrenal disorders.

Adrenalectomy Surgery

Adrenalectomy means surgical removal of one adrenal gland, or occasionally part of one gland. Surgery may be recommended when a tumor produces excess hormones, appears suspicious for cancer, grows significantly, causes symptoms, or carries a risk of complications.

Many procedures can be performed with minimally invasive laparoscopic or robotic techniques. Larger tumors or tumors suspected of being cancerous may require open surgery so the surgeon can remove the mass safely and completely.

Treatment for Adrenal Cancer

Treatment for adrenocortical carcinoma usually involves surgery when the tumor can be removed. Depending on the stage and individual situation, treatment may also include mitotane, chemotherapy, radiation therapy, immunotherapy, targeted approaches, or clinical trials.

Because adrenal cancer is rare, treatment is often best coordinated through a multidisciplinary team that may include an endocrinologist, endocrine surgeon, medical oncologist, radiation oncologist, genetic counselor, and specialized imaging experts.

Hormone Replacement After Treatment

Removing one adrenal gland usually does not cause permanent adrenal insufficiency because the remaining gland can often produce enough hormones. However, some people need temporary cortisol replacement after surgery, and those who lose function in both adrenal glands require lifelong hormone replacement therapy.

When to Seek Medical Care

Schedule a medical appointment if you have persistent unexplained high blood pressure, low potassium, new episodes of severe sweating and palpitations, ongoing abdominal or flank pain, rapidly changing hormone-related symptoms, or unexplained weight changes with muscle weakness.

Seek urgent emergency care for severe chest pain, fainting, symptoms of stroke, severe shortness of breath, confusion, or a sudden severe blood pressure crisis. These symptoms may have several causes, but they should never be brushed off as “probably just stress.”

What the Adrenal Tumor Experience Can Feel Like: The Practical Human Side

Learning that you have an adrenal mass can feel strange because the discovery often begins with a sentence that sounds almost casual: “Your scan showed something on your adrenal gland.” That is a lot to process when you may have gone in expecting answers about back pain, kidney stones, a stomach problem, or another unrelated issue.

One of the first emotional hurdles is uncertainty. Many people immediately hear the word “tumor” and mentally jump straight to cancer. In reality, adrenal masses vary widely. Some are benign and nonfunctional. Some make hormones but are treatable. Some need surgery. A smaller number are cancerous. The waiting period between a scan, lab work, specialist appointments, and a final plan can be more exhausting than people expect.

The hormone-testing process can also feel oddly specific. A clinician may ask about sweating episodes, blood pressure readings, headaches, sleep, bruising, muscle weakness, menstrual changes, potassium levels, anxiety-like spells, or unusual weight changes. At first, these questions can seem disconnected. Later, they begin to make sense: each symptom is a clue about which hormone, if any, may be out of balance.

A practical way to make appointments easier is to keep a simple symptom and medication timeline. Write down blood pressure readings, episodes of headache or palpitations, major weight changes, sleep problems, test dates, and questions for your care team. This is not about becoming your own full-time medical detective with a corkboard and red string. It is about making the pattern easier for your clinicians to see.

People with functional tumors may feel relieved when a name is finally attached to symptoms that have been dismissed as stress, aging, anxiety, or “one of those things.” For example, someone with repeated headaches, sweating, and sudden heart racing may have spent months wondering whether they were having panic attacks. Someone with difficult blood pressure and low potassium may finally learn that an adrenal hormone is part of the story.

Surgery can bring a different set of emotions. Even when a procedure is minimally invasive, it is still surgery, and recovery is not always as simple as a few tiny incisions suggest. Energy levels may take time to return. Blood pressure medicines may need adjustment. Hormone levels may be rechecked repeatedly. The body is very good at adapting, but it appreciates a little patience while it does the paperwork.

Follow-up care matters, especially after treatment for a hormone-producing tumor or adrenal cancer. Imaging, lab tests, blood pressure checks, and specialist visits can become part of the routine. This can be reassuring because it provides a plan, but it can also create scan-related anxiety. It helps to ask the care team what each follow-up test is checking and what changes would actually matter.

Support can make the process more manageable. A partner, friend, family member, or trusted person can take notes during appointments, help organize records, and remind you that medical terminology is not a personality test. You do not have to understand every hormone pathway on the first visit. Asking questions, requesting plain-language explanations, and seeking a second opinion at an experienced adrenal center are reasonable parts of making informed decisions.

The most useful takeaway is this: an adrenal gland tumor is a diagnosis category, not a final verdict. Care becomes clearer once doctors determine whether the tumor is benign or malignant, functional or nonfunctional, stable or changing. Getting the right testing and the right specialists turns a frightening mystery into a plan with actual next steps.

Final Thoughts

Adrenal gland tumors range from harmless incidental findings to hormone-producing conditions and rare adrenal cancers. The key is not panicit is proper evaluation. Symptoms such as resistant high blood pressure, low potassium, severe sweating episodes, headaches, palpitations, unexplained weight changes, or persistent abdominal pain deserve medical attention when they continue or worsen.

With accurate hormone testing, detailed imaging, and care from an experienced team, many adrenal tumors can be safely monitored, treated with medication, removed surgically, or managed with cancer-directed therapy. Tiny glands, big job, very real science.

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