Adrenal

Adrenal glands can be either malignant (cancer) or benign (non-cancer). These tumours can cause different symptoms depending on their size and if they are producing hormones.

Primary hyperaldosteronism,or Conn’s Syndrome, a condition where too much aldosterone is produced by the adrenal glands. This causes the body to retain sodium and fluid, while losing potassium in the blood. Symptoms may include high blood pressure, low blood potassium levels and muscle weakness.
Cushing’s syndrome is also caused by an adrenal tumour. Symptoms may include moon face (round, puffy face), buffalo hump (an increase in fat pads just below the back of the neck), truncal obesity (increase in weight around the abdomen), wasting of your muscles, easy bruising, facial hair, purplish “stretch marks” on your abdomen, high blood pressure and changes in emotions from feelings of high to low.

Pheochromocytoma is a rare adrenal tumour, 10% of which may occur outside the adrenal gland. While usually benign, 10% may be malignant. Symptoms can include headache, sweating, palpitations (rapid heart beats), and high blood pressure. There will also be high levels of catecholamines (adrenaline) in the urine and blood.

Investigations may include blood and urine tests, CT scans, nuclear medicine scan, or adrenal vein sampling.

Most adrenal tumours can be removed by a surgical procedure called laparoscopic adrenalectomy. This is performed under general anaesthesia. The patient is positioned on their side. 4 small incisions are made on the same side as the adrenal gland to be removed. One incision may need to be extended a little to facilitate removal of the tumour. In a small number of patients with large tumours (>6cm) it may be necessary to convert a laparoscopic adrenalectomy to an open adrenalectomy. This usually involves a large upper abdominal incision. For some patients, an open adrenalectomy may be preferable initially. Your surgeon will explain your specific surgery and why it is recommended in your case.

There is a risk of bleeding and extreme changes in blood pressure. The risk of infection is so low that antibiotics are not routinely used. There is also a very low risk of pneumonia, injury to bowel, spleen, pancreas or liver. Post-operatively, you will be closely monitored for changes in blood pressure that may occur. You will be able to eat a normal diet after surgery. There is also a small risk associated with anaesthesia. However, the relative risk of complications is very low and is usually outweighed by the potential benefits of having the surgery. We will go over this information with you and answer any questions you might have.

Recovery is usually achieved in 1-2 weeks after a laparoscopic adrenalectomy and 5-6 weeks after an open procedure.