Incidentaloma (patient information)

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Incidentaloma

Overview

What are the symptoms?

What are the causes?

Who is at highest risk?

Diagnosis

When to seek urgent medical care?

Treatment options

Where to find medical care for Incidentaloma?

Prevention

What to expect (Outlook/Prognosis)?

Possible complications

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

An adrenal incidentaloma is an unsuspected tumor in one or both of your adrenal glands. This type of tumor is usually found by chance during an imaging test, such as an ultrasound or CT scan, for another condition. A tumor can be benign (non-cancerous) or malignant (cancerous).

What are the Symptoms of Incidentaloma?

Symptoms vary depending on whether the tumor is non-functional or functional, and which, if any, hormones are produced in excess.

Symptoms of too much cortisol can include:

  • Weight loss or weight gain (especially around the face and abdomen)
  • Purplish skin stretch marks or skin that’s easily bruised
  • Acne
  • Muscle weakness
  • Depression, anxiety, fatigue, and sleep disturbances
  • In women, excess facial and body hair and/or irregular periods

High levels of cortisol can also cause high blood pressure, high blood sugar, and low bone density (when the tissue inside your bones starts to thin).

Symptoms of too much norepinephrine or epinephrine can include:

  • Fast or irregular heartbeat
  • Sweating
  • Severe headaches
  • Shakiness
  • Pale face

High levels of these hormones can also cause high blood pressure.

High levels of aldosterone can cause high blood pressure, which can be life-threatening if not treated, and sometimes muscle weakness.

What Causes Incidentaloma?

There are a number of causes. Some causes can make your adrenal glands produce too much of a hormone. This type of tumor is called a hormonally active or functional tumor. Hormonally active causes include:

  • Cushing syndrome or subclinical hypercortisolism: conditions caused by too much cortisol
  • Hyperaldosteronism: too much aldosterone
  • A pheochromocytoma: a rare tumor in the adrenal glands that leads to too much epinephrine and norepinephrine
  • Congenital adrenal hyperplasia: an inherited condition in which the adrenal glands make too little cortisol and aldosterone, and too much androgen
  • Cancer of the adrenal gland with too much cortisol, adrenal androgens, and/or aldosterone

Other types of causes do not result in excess hormone production. This type of tumor is called a non-functional tumor. Causes include:

  • An adenoma (a non-cancerous tumor in the adrenal glands)
  • Cancer of the adrenal gland or spread of cancer from elsewhere in the body
  • Cysts in or on the adrenal glands
  • Other less common conditions, such as tumors filled with fat and blood cells

Who is at Highest Risk?

Diagnosis

Your doctor will evaluate your tumor to identify its cause and hormone production. This may include:

  • Your medical history
  • A review of your symptoms
  • A physical exam: a check of your blood pressure, pulse rate, body weight, and other signs
  • Blood and/or urine tests to check hormone levels and to rule out pheochomocytomas
  • Results of genetic tests (as needed)

Your doctor also will need to know your family history of adrenal tumors, other kinds of tumors, syndromes that come with tumors, high blood pressure, or Cushing syndrome.

When to Seek Urgent Medical Care?

Treatment Options

About 85% of adrenal tumors are non-functioning and may not need treatment. Sometimes surgery is needed to remove the tumor, or one or both adrenal glands. Your medical team will decide whether you need surgery based on your type of tumor (benign or cancerous) and whether it is producing hormones. Some people may need hormone treatment. If you have an inherited tumor syndrome, you may need genetic counseling.

If you’ve had an adrenal incidentaloma, you may need regular follow-up, perhaps for several years.

Where to find Medical Care for (Disease name)?

Medical care for Incidentaloma can be found here.

Prevention

What to Expect (Outlook/Prognosis)?

Possible Complications

Sources

http://www.nlm.nih.gov/medlineplus/ency/article/000434.htm


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