Adrenal Tumors: Symptoms, Diagnosis, and Management

Adrenal tumor

Right abdominal pain with many similar bruises on the thigh and right abdomen.
However, upon examination at the hospital, an incidental finding of a 3 cm adrenal tumor was discovered.
The urologist conducted blood and urine tests for the adrenal gland, and the results showed abnormalities.
The doctor stated that no follow-up or treatment is necessary.
I often feel very fatigued and sleepy during work, relying on coffee to stay alert, but in the evenings after work, I feel very energetic and have trouble sleeping.

Feng, 30~39 year old female. Ask Date: 2019/02/22

Dr. Hong Yuanbin reply Internal Medicine

Hello,
1.
I'm not sure what you mean by "abnormal findings in the examination report." Generally, adrenal tumors are initially classified as benign or malignant based on imaging reports, particularly computed tomography (CT) scans.
If the tumor is malignant, it certainly requires intervention.
If it is benign, we will assess whether it is a functional tumor, meaning whether it secretes abnormal hormones, to determine if treatment is necessary.
2.
Abdominal pain and bruising are not common symptoms of adrenal tumors.
If these symptoms persist, further examination and follow-up are recommended.
3.
The fatigue you mentioned from work is also not a common symptom of adrenal tumors.
I suggest making adjustments through regular exercise and a consistent routine.
Thank you for your inquiry.

Reply Date: 2019/02/22

More Info

Adrenal tumors, particularly pheochromocytomas, can present with a variety of symptoms and diagnostic challenges. Pheochromocytomas are tumors that arise from the adrenal glands and can lead to excessive production of catecholamines, which are hormones that can cause significant physiological effects. Understanding the symptoms, diagnosis, and management of adrenal tumors is crucial for effective treatment and patient care.

Symptoms of Adrenal Tumors
Patients with adrenal tumors may experience a range of symptoms, which can vary depending on the type of tumor and the hormones it produces. Common symptoms of pheochromocytoma include:
1. Hypertension: Persistent high blood pressure is one of the hallmark symptoms due to excess catecholamines.

2. Palpitations: Patients may feel their heart racing or pounding.

3. Sweating: Excessive sweating, often described as "cold sweats," can occur.

4. Headaches: Severe headaches can be a result of elevated blood pressure.

5. Anxiety or Panic Attacks: The surge of catecholamines can lead to feelings of anxiety or panic.

6. Fatigue: Patients may feel unusually tired or fatigued, as you mentioned in your case.

In your situation, the right abdominal pain and bruising-like symptoms could be related to the tumor's effects on the body, including potential vascular changes or even bleeding within or around the tumor. The fatigue and sleep disturbances you experience may also be linked to hormonal imbalances caused by the adrenal tumor.

Diagnosis of Adrenal Tumors
The diagnosis of adrenal tumors typically involves a combination of imaging studies and biochemical tests. In your case, the following steps were likely taken:
1. Imaging Studies: CT scans or MRIs are commonly used to visualize the adrenal glands and identify any tumors. Your report indicated a 3 cm adrenal tumor, which is significant enough to warrant further investigation.

2. Biochemical Testing: Blood and urine tests are essential for assessing hormone levels. Elevated levels of catecholamines or their metabolites (such as metanephrines) can confirm the diagnosis of pheochromocytoma.

3. Histological Examination: If surgery is performed, the tumor can be examined histologically to confirm the diagnosis and rule out malignancy.

Management of Adrenal Tumors
Management strategies for adrenal tumors depend on the type of tumor, its size, and whether it is functional (hormone-producing) or non-functional. In the case of pheochromocytoma, the following approaches are typically considered:
1. Surgical Intervention: If the tumor is confirmed to be a pheochromocytoma and is causing significant symptoms or complications, surgical removal of the tumor (adrenalectomy) is often the treatment of choice. Given that your tumor is 3 cm, surgical evaluation may be warranted, especially if it is functional.

2. Medical Management: In cases where surgery is not immediately indicated, or if the patient is not a surgical candidate, medications may be used to manage symptoms. Alpha-blockers are often prescribed to control hypertension and other symptoms associated with catecholamine excess.

3. Regular Monitoring: If the tumor is small and asymptomatic, regular follow-up with imaging and biochemical testing may be recommended to monitor for any changes.

Conclusion
In summary, adrenal tumors, particularly pheochromocytomas, can lead to significant symptoms and require careful diagnosis and management. Your symptoms of fatigue and sleep disturbances, along with the discovery of a 3 cm adrenal tumor, warrant a thorough evaluation by your healthcare team. It is essential to discuss your symptoms and concerns with your physician, who can provide guidance on the best course of action, including potential surgical intervention or medical management. Regular follow-up and monitoring will be crucial in managing your condition effectively.

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