Medical history and physical examination
if you havesigns or symptomsthat suggest adrenal cancer, the first step is usually for your doctor to take your full medical history to find out more about them.
- Your doctor will want to know if anyone in your family has had adrenal cancer or any other type of cancer.
- Your doctor may also ask about your menstrual or sexual function and any other symptoms you may have.
A physical exam will provide other information about possible symptoms of adrenal cancer or other health problems.
- Your doctor will carefully examine your abdomen for the presence of a tumor (or mass).
- Your blood and urine will likely be tested for high levels of hormones produced by some adrenal tumors.
- If an adrenal tumor is suspected, imaging tests will be done to find it. These tests can also help see if it has spread.
If a mass is seen on the imaging test and it is likely to be adrenal cancer, doctors will recommendsurgeryto remove the cancer. Generally, doctors do not recommend a biopsy (removal of a sample of a tumor to be viewed under a microscope to see if it is cancerous) before surgery to remove the tumor. This is because a biopsy can increase the risk of adrenal cancer spreading beyond the adrenal glands.
X-ray of the chest
INX-ray of the chestcan show whether the cancer has spread to the lungs. It may also be helpful to find out if you have serious lung or heart conditions.
Ultrasound examinationsuse sound waves to take pictures of body parts. A device called a transducer produces sound waves that bounce off tissues and organs in the body. The echo pattern of the sound wave is detected by the transducer and analyzed by the computer to create an image of these tissues and organs. This test can show if there is a tumor in the adrenal glands. It can also show tumors in the liver if the cancer has spread there. In general, ultrasound is not used to look for adrenal tumors unless a CT scan cannot be performed for some reason.
computed tomography (CT)
computed tomographythey show the adrenal glands quite clearly and can often confirm the location of the tumor. It can also help show whether the cancer has spread to the liver or other nearby organs. CT scans can also show lymph nodes and distant organs where metastatic cancer may be present. A CT scan can help determine if surgery is a good treatment option.
Magnetic Resonance Imaging (MRI)
Like computed tomography,MRI scansshow detailed images of soft tissue in the body. But MRI scans use radio waves and strong magnets instead of X-rays. An MRI can sometimes provide more information than a CT scan because it can better distinguish adrenal cancer from benign tumors.
MRI scans are particularly useful for examining the brain and spinal cord. In people with suspected adrenal tumors, a brain MRI may be performed to examine the pituitary gland. Tumors of the pituitary gland, which lies below the front of the brain, can cause symptoms similar to an adrenal tumor.
Positron emissionstomografi (PET)
ToHOLLY LOVEDDuring the scan, you are injected with a slightly radioactive form of sugar, which mainly accumulates in cancer cells. A special camera then creates an image of the areas of radioactivity in the body. The image is not as detailed as a CT or MRI scan, but a PET scan can look for possible areas of cancer that has spread to all areas of the body at once.
Some machines perform both PET and CT scanning simultaneously (PET/CT scanning). This allows the doctor to see in more detail the areas that "light up" on the PET scan.
PET scans can be helpful in determining whether an adrenal tumor may be benign or malignant (cancer) and whether it may have spread.
A laparoscope, a thin, flexible tube with a small video camera on the end, is inserted through a small surgical opening in the patient's side so the surgeon can see where the cancer is growing. It can be used to detect distant spread as well as enlarged lymph nodes (which may contain cancer). They are sometimes combined with ultrasound to get a better picture of the cancer. A laparoscopy may be performed to help predict whether it will be possible to remove the cancer completely with surgery. In addition to viewing adrenal tumors through the laparoscope, surgeons can sometimes remove small benign adrenal tumors with this instrument. This method is described inAdrenal cancer surgery.
Imaging tests can detect tumors, but often the only way to be sure that a tumor is cancer is to take a sample of the tumor tissue and look at it under a microscope. it is calledbiopsy.
Because adrenal adenomas (benign tumors) and carcinomas can look similar under a microscope, a biopsy may not be able to tell whether an adrenal tumor is cancer. A needle biopsy of adrenal cancer can actually also spread cancer cells. For these reasons, preoperative biopsies are generally not performed if the size of the adrenal tumor and certain imaging features suggest that it is most likely cancer. Blood hormone tests and imaging tests are more useful than biopsies in diagnosing adrenal cancer.
If the cancer appears to have metastasized (spread) to another part of the body, such as the liver, a needle biopsy of the metastasis may be performed. If a patient is known to have an adrenal tumor and a liver biopsy shows the presence of adrenal cells in the liver, then the tumor is cancer.
In general, a biopsy is only performed on a patient with adrenal cancer when the tumors are outside the adrenal glands and the doctor needs to know whether these tumors are from adrenal cancer or caused by another cancer or disease. Adrenal tumors are sometimes biopsied when a patient is known to have another type of cancer (such as lung cancer), and knowing whether it has spread to the adrenal glands will change treatment.
Blood and urine tests for adrenal hormones
Blood and urine tests to measure adrenal hormone levels are important in determining whether a patient with signs and symptoms of adrenal cancer has the disease. For urine samples, you may be asked to collect all your urine for 24 hours. Blood and urine tests are as important as imaging tests in diagnosing adrenal cancer. Doctors can choose which tests to perform based on the patient's symptoms. But often doctors check hormone levels even when there are no symptoms of high hormone levels. This is because the symptoms of abnormal hormone levels can be very subtle and blood tests can detect changes in hormone levels even before symptoms develop.
High cortisol tests
Cortisol levels are measured in the blood and urine. If an adrenal tumor is producing cortisol, these levels will be abnormally high. These tests may be done after you have received a dose of dexamethasone. Dexamethasone is a drug that acts like cortisol. If given to someone who does not have an adrenal tumor, it will lower levels of cortisol and similar hormones. In a person with a tumor in the adrenal cortex, the level of these hormones will remain high after receiving dexamethasone. Blood levels of another hormone called ACTH will also be measured to help distinguish adrenal tumors from other diseases that can cause high cortisol levels.
Test for high aldosterone levels
The aldosterone level will be measured and will be high if the tumor is producing aldosterone. High levels of aldosterone can also lead to low blood levels of potassium and renin (a hormone produced by the kidneys).
Tests for high levels of androgens or estrogens
Patients with androgen-producing tumors will have high levels of dehydroepiandrosterone sulfate (DHEAS) or testosterone. Patients with estrogen-producing tumors will have high levels of estrogen in their blood.
American Cancer Society medical content and editorial team Our team consists of oncology doctors and nurses with deep knowledge of oncology treatment as well as journalists, editors and translators with extensive experience in writing medical texts.
American Cancer Society medical content and editorial team
Our team consists of oncology doctors and nurses with deep knowledge of oncology treatment as well as journalists, editors and translators with extensive experience in writing medical texts.
Groussin L, Bonardel G, Silvera S, et al. Positron emission tomography with 18F-fluorodeoxyglucose for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients.J Clin Endocrinol Metab. 2009;94(5):1713-1722. Epub 2009 Feb 3. Lalli E, Sasano H. 5th International ACC Symposium: A review of current and future research in the biology of adrenocortical carcinoma: diagnostic and therapeutic applications.Horm can. 2016;7:44-48. Lirov R, Tobias E, Lerario AM, Hammer GD. Liver tumors In: DeVita VT, Lawrence TS, Rosenberg SA, editors.DeVity, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology.10. Philadelphia, PA: Lippincott Williams & Wilkins 2015: Kapitel 84. Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancers of the Endocrine System W: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds.Abeloff Clinical Oncology.5 units Philadelphia, PA. Elsevier: 2014: 1112-1142. Song JH, Chaudhry FS, Mayo-Smith WW. Incidental adrenal mass on CT: incidence of adrenal disease in 1049 consecutive adrenal masses in patients without known malignancy.AJRAM J Roentgenol.2008;190:1163-1168. Song JH, Mayo-Smith WM. The current state of imaging of adrenal tumors.Surg Oncol Clin N Am. 2014;23:847-861. Sturgeon C, Shen WT, Clark OH et al. Risk assessment in 457 adrenocortical carcinomas: how much tumor size predicts the likelihood of malignancy.J Am Coll Surg.2005:423-430.
Groussin L, Bonardel G, Silvera S, et al. Positron emission tomography with 18F-fluorodeoxyglucose for the diagnosis of adrenocortical tumors: a prospective study in 77 operated patients.J Clin Endocrinol Metab. 2009;94(5):1713-1722. Epub 2009 Feb 3.
Lalli E, Sasano H. 5th International ACC Symposium: A review of current and future research in the biology of adrenocortical carcinoma: diagnostic and therapeutic applications.Horm can. 2016;7:44-48.
Lirov R, Tobias E, Lerario AM, Hammer GD. Liver tumors In: DeVita VT, Lawrence TS, Rosenberg SA, editors.DeVity, Hellman, and Rosenberg's Cancer: Principles and Practice of Oncology.10. Philadelphia, PA: Lippincott Williams & Wilkins 2015: Kapitel 84.
Schneider DF, Mazeh H, Lubner SJ, Jaume JC, Chen H. Cancers of the Endocrine System W: Neiderhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds.Abeloff Clinical Oncology.5 units Philadelphia, PA. Elsevier: 2014: 1112-1142.
Song JH, Chaudhry FS, Mayo-Smith WW. Incidental adrenal mass on CT: incidence of adrenal disease in 1049 consecutive adrenal masses in patients without known malignancy.AJRAM J Roentgenol.2008;190:1163-1168.
Song JH, Mayo-Smith WM. The current state of imaging of adrenal tumors.Surg Oncol Clin N Am. 2014;23:847-861.
Sturgeon C, Shen WT, Clark OH et al. Risk assessment in 457 adrenocortical carcinomas: how much tumor size predicts the likelihood of malignancy.J Am Coll Surg.2005:423-430.
Last seen:January 2, 2018
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- Blood and urine tests. ...
- Biopsy. ...
- CT or CAT scan. ...
- MRI. ...
- Metaiodobenzylguanidine (MIBG) scan. ...
- Adrenal vein sampling (AVS). ...
- DOTATATE positron emission tomography (PET) or PET-CT scan.
Blood and urine tests
Both blood and urine samples should be taken and analyzed for abnormal hormone levels. Patients with adrenal adenomas and carcinomas tend to have increased production of the hormones produced in the adrenal gland, which can be detected in blood and urine tests.
It's often hard to tell if an adrenal tumor is cancer (malignant) or benign. If the tumor grows and spreads to lymph nodes or other parts of the body, it's cancer. Benign tumors don't spread.What blood test is done to check adrenal glands? ›
A cortisol test is used to help diagnose medical conditions that cause too much or too little cortisol. These conditions include disorders that affect the adrenal glands: Cushing's syndrome is a disorder that happens when your body has too much cortisol over a long period of time.What labs indicate adrenal tumor? ›
Blood and Urine Tests
Doctors may use blood or urine tests to check for abnormal levels of hormones in the body, which may be produced by adrenal tumors. Doctors can test some hormone levels in your blood. In some instances, doctors may need to test samples of your urine that are collected over a 24-hour period.
Blood and urine tests help measure the amount of adrenal hormones, which can detect a functional tumor. A computed tomography (CT or CAT) scan or a magnetic resonance imaging (MRI) scan may be useful in diagnosing an adrenal gland tumor and determining whether it is cancerous.What is the common age for adrenal cancer? ›
The average age of patients with adrenal cancer is around 46, but adrenal cancer can occur in people of any age, even in children.Can adrenal cancer go undetected? ›
With malignant adrenal cancer (cancer that may spread), adrenal cancer symptoms often go undetected until the cancer is in an advanced stage. Adrenal cancer symptoms that do develop vary depending on the stage of the tumor and the kind of hormone secreted.What are 3 diseases that affect the adrenal glands? ›
- Addison's disease, also called adrenal insufficiency. In this disorder, you don't produce enough cortisol and/or aldosterone.
- Cushing's syndrome. ...
- Congenital adrenal hyperplasia. ...
- Adrenal gland suppression. ...
- Hyperaldosteronism. ...
As an adrenal cancer grows, it presses on nearby organs and tissues. This may cause pain near the tumor, a feeling of fullness in the abdomen, or trouble eating because of a feeling of filling up easily.
"Is it cancer?" is a very common question we hear at the Carling Adrenal Center. It is important to know that adrenal cancer is quite rare and over 95% of adrenal masses and growths are benign.What does adrenal pain feel like? ›
Symptoms of Adrenal Cancer
This can manifest itself as flank, or abdominal pain or as an increase of girth (a growing waist line). Fluctuations in weight can also be seen, both weight loss and weight gain. About half of all adrenocortical cancers overproduce cortisol.
The ACTH stimulation test is the test used most often to diagnose adrenal insufficiency. In this test, a health care professional will give you an intravenous (IV) injection of man-made ACTH, which is just like the ACTH your body makes.What bloodwork shows adrenal fatigue? ›
ACTH Stimulation Test This is the most specific test for diagnosing adrenal insufficiency.What percentage of adrenal tumors are cancerous? ›
“Although the majority of these tumors are benign, around 30% of adrenal tumors (>4cm) are malignant (most represented by ACCs), and the survival rate for these patients is very poor unless detected early.”What is the life expectancy of someone with adrenal gland cancer? ›
If the cancer has spread to the surrounding tissues or organs and/or the regional lymph nodes, the 5-year relative survival rate is 54%. If the cancer has spread to a distant part of the body, the 5-year relative survival rate is 38%.Can an ultrasound detect adrenal cancer? ›
The most common adrenal masses are tumors incidentally detected in imaging examinations (ultrasound, tomography, magnetic resonance imaging), referred to as incidentalomas. They include a range of histopathological entities but cortical adenomas without hormonal hyperfunction are the most common.