An adrenal gland tumor is an abnormal growth in the adrenal glands, which can vary in size, behavior, and hormone production.

The adrenal glands, positioned like small triangles above each kidney, play a key role in hormone production. These hormones regulate various bodily functions.

Most adrenal tumors are nonfunctioning, meaning that they don’t produce excess hormones and pose minimal health risks. However, some can lead to hormone overproduction, resulting in related health issues.

A tumor can also be benign (noncancerous) or malignant (cancerous), which affects your treatment plan. However, the vast majority of adrenal gland tumors are benign.

An adrenal gland tumor is an abnormal growth in the adrenal glands. The most common type is adrenal adenomas, while rarer tumors include pheochromocytomas (affecting adrenaline), adrenocortical carcinomas (adrenal cancer), and neuroblastomas (mainly affecting children).

The vast majority of adrenal adenomas are benign (noncancerous), and these can be either functioning or nonfunctioning. Functioning ones produce excessive hormones like cortisol, aldosterone, or adrenaline, leading to specific health problems, while nonfunctioning ones don’t produce such hormones.

Adrenal tumors that are hormonally active (functioning), regardless of whether they’re benign or malignant, often cause symptoms due to the excessive hormones they produce. Research suggests that about 15% of incidental adrenal tumors (tumors discovered during scans for other health issues) cause hormone overactivity.

Cortisol-producing adrenal tumors, which cause Cushing syndrome, may include the following symptoms:

Symptoms of aldosterone-secreting adrenal tumors may include:

Hormonally inactive (nonfunctioning) adrenal adenomas:

  • typically don’t cause symptoms
  • are often discovered incidentally on abdominal imaging

Pheochromocytoma tends to present differently than other adrenal tumors. Symptoms may include:

Nonfunctioning adrenal tumors can cause symptoms if they grow large enough to press on surrounding organs, nerves, or blood vessels, leading to discomfort or pain.

Research shows that nonfunctioning adrenal tumors have a chance of becoming hormonally active over time:

  • 17% within 1 year
  • 29% within 2 years
  • 47% within 5 years

The likelihood of an adrenal adenoma turning into a cancerous tumor is very low.

Determining whether an adrenal tumor is cancerous usually involves a medical evaluation, imaging tests, and sometimes a biopsy.

Here are some steps that medical professionals might take to determine the nature of an adrenal tumor:

  • Imaging tests: CT scans, MRIs, and ultrasounds can help visualize the tumor’s size, location, and characteristics.
  • Hormone function tests: Blood tests can help determine whether a functioning tumor is producing excessive amounts of hormones like cortisol, aldosterone, or adrenaline.
  • Biopsy: A biopsy may be performed if there’s a strong suspicion that the tumor might be cancerous.
  • Imaging characteristics: Malignant tumors may show irregular shapes, rapid growth, invasion into nearby tissues, or the presence of certain types of tissue patterns.
  • Size and growth rate: Generally, larger adrenal tumors are more likely to be cancerous. In a study of 76 people with nonfunctioning adrenal tumors, the malignancy rates were 0% for tumors less than 4 centimeters in diameter, 2.9% for tumors between 4–6 centimeters, and 13.6% for tumors larger than 6 centimeters.
  • Urine test: A urine test for metanephrines may also be used for the evaluation of pheochromocytoma.

What percent of adrenal tumors are cancerous?

While benign tumors in the adrenal gland are common, cancers in or around the adrenal gland are very rare. These cancers are found in only 1 to 3 out of 1 million people, according to the Urology Care Foundation.

Of the adrenal adenomas found incidentally, about 5% are malignant.

The exact cause of adrenal gland tumors remains unclear. It’s believed that a combination of genetic mutations, hormonal influences, and environmental factors likely contributes to their development.

Factors such as obesity and tobacco use might increase the likelihood of developing adrenal adenoma.

A study of 2,005 people with adrenal incidentalomas (AIs) found that AIs were most common among those in their 70s. Hypertension, glucose disorders (diabetes), and high cholesterol were also prevalent.

Certain genetic conditions are also associated with an increased risk of adrenal tumors, including:

  • familial adenomatous polyposis (FAP)
  • multiple endocrine neoplasia, type 1 (MEN1)
  • Li-Fraumeni syndrome
  • Carney complex
  • neurofibromatosis type 1
  • multiple endocrine neoplasia type 2 (MEN2)

Nonfunctioning benign adrenal adenomas typically don’t require treatment.

Surgery may be recommended for larger or potentially cancerous tumors, as well as smaller tumors causing hormone-related issues. Small inactive tumors are closely watched, and surgery might be considered if they grow or start producing hormones.

For individuals who can’t undergo surgery, medications like spironolactone can help manage excessive hormone production.

What is the survival rate of adrenal tumors?

Most adrenal tumors are benign and therefore not deadly.

Here are the 5-year relative survival rates for adrenal cancer, according to the American Cancer Society:

  • Localized stage (confined to origin): 73%
  • Regional stage (spread to nearby areas): 53%
  • Distant stage (spread to distant organs): 38%
  • All stages combined: Average survival is 50% at 5 years.

Adrenal gland tumors are abnormal growths with varying size, behavior, and hormone production. Most are benign and nonfunctioning, but some are cancerous.

It’s important to note that not all adrenal tumors, even if they’re hormonally active, will cause symptoms. Regular medical check-ups and imaging can aid in detecting asymptomatic tumors and managing any symptoms that arise.