The Adrenal Glands are a pair of organs situated above the kidneys. These glands normally secrete several hormones which are important in maintaining normal body functions. These hormones include cortisol, aldosterone, and adrenaline. Cortisol is important in regulating glucose and fat metabolism. Aldosterone maintains blood volume and normal levels of sodium and potassium. Adrenaline is also produced by the adrenal glands. These molecules are also important in the body's response to stress.
Tumours of the Adrenal Glands are fairly uncommon. Due to their deep location, Adrenal masses are not usually felt by the patient or doctor. Clues to the presence of an Adrenal mass include symptoms of increased hormone secretion. Symptoms of excess cortisol, also known as Cushing's syndrome are weight gain, fatty deposits in the abdomen and poor wound healing. Symptoms of excess aldosterone production, include hypertension and abnormally low blood levels of the mineral potassium. Tumours that produce excess adrenaline are called phaeochromocytomas.
Adrenal lesions are diagnosed either by symptoms or signs such as hypertension, abnormal salt content on blood tests, or abnormal fat deposition as seen in Cushing’s disease. Many Adrenal lesions are detected incidentally when having imaging studies such as ultrasound or CT scans for other reasons. Often further investigations are necessary to establish a diagnosis and these can include a higher quality contrast enhanced CT scan, an MRI scan, or sometimes a MIBG nuclear medicine scan. Blood and urine tests may also be necessary to make a diagnosis.
Biopsy of the any Adrenal lesion should only be performed after consultation with an experienced surgeon, as biopsy needles can seed or spread any tumours, and it is often possible to make a diagnosis without the need for a biopsy.
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