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Home Disease Index Adrenal Adenomas

pituitary adenomas, adrenal disorders, adrenal crisis, adrenal diseases, adrenal deficiency, adrenal problems, adrenal mass, adrenal cortisol, adrenal disorder

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Overview

Causes
Symptoms
Risk Factor

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What is an adrenal adenoma?

 


The adrenal glands are situated over the top of each kidney. Adrenal adenomas are benign (non-cancerous) tumours of the adrenal gland. They arise from the outer layer of the gland, called the adrenal cortex. The adrenal cortex normally makes hormones that belong to the steroid family. If an adrenal adenoma produces hormones, it is called 'functioning', though this term makes them sound healthy when in fact such adenomas often produce excessive amounts of steroid hormones. If an adenoma does not produce a hormone it is termed 'non-functioning'.

Adrenal adenomas
are often found by chance during a scan of the body for an unrelated condition. However, all adrenal masses (lumps) need careful evaluation to ascertain their nature, especially to see whether they are producing hormones. If an adrenal adenoma that is producing hormones is not treated, it can have serious consequences.



What causes adrenal adenomas?

 


The cause of adrenal adenomas is unknown, but the current accepted theory is that they arise because of mutations (changes) in certain genes (which are not yet identified). Adrenal adenomas are more common in some inherited diseases, including multiple endocrine neoplasia type I, Beckwith-Wiedemann syndrome and the Carney complex. Also, patients with genetic defects of the body systems that manufacture steroid hormones (eg congenital adrenal hyperplasia), especially those whose condition is poorly controlled, may have a higher risk of adrenal adenomas. However, most adrenal adenomas are not linked with an inherited disease. The likelihood of developing an adenoma increases with age. Benign adrenal adenomas are found in 1-32 per cent of people at autopsy, with most studies showing a detection rate of about 5 per cent. About 6 per cent of patients over 60 years of age harbour an adrenal adenoma. No other predisposing factors have been defined, and prevention is not possible.



What are the symptoms?

 


Most patients with an adrenal adenoma will have no symptoms caused by the adenoma. However, even in symptom-free patients, proper investigations reveal that many adrenal adenomas produce abnormal amounts of steroid hormones to some degree. The commonest abnormality is the production of too much cortisol, a steroid hormone involved in the response to stress and energy balance. Adenomas that produce massive amounts of steroid hormones will cause obvious symptoms. Large amounts of cortisol will cause Cushing's syndrome, too much aldosterone causes Conn's syndrome, and an excess of male sex steroids causes acne and hair growth. Very rarely, bleeding can occur into adenomas and cause pain in the flanks or back.



Risk Factor

 


Many children simply outgrow ADHD. About half of those affected appear to function normally by young adulthood, but a significant number will have problems that persist into adult life. These may take the form of depression, irritability, antisocial behaviour and attention problems.

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