The adrenal glands, two glands located above each kidney, produce hormones that affect the storage and use of energy, blood volume, blood pressure, sex organs and stress responses. Tumors in the adrenal glands occur when the cells in either the inner portion, known as the adrenal medulla, or outer portion, known as the adrenal cortex, grow abnormally and uncontrollably. Although doctors may only observe small adrenal tumors, any adrenal tumor greater than 4 cm should be surgically removed, according to the University of Southern California Department of Surgery.
Types
Each adrenal gland consists of the adrenal medulla surrounded by the adrenal cortex. Pheochromocytoma describes a rare type of tumor in the adrenal medulla. Although usually benign, meaning the tumor fails to spread to other tissues, pheochromocytoma causes the adrenal glands to secrete increased levels of adrenaline and noradrenaline and can therefore become life-threatening, according to MayoClinic.com.
Adrenocortical carcinoma describes a cancerous tumor in the adrenal cortex. This type of tumor causes the adrenal gland to produce increased levels cortisol, a corticosteroid; aldosterone, a hormone that stimulates the reabsorption of salt and water; and estrogen, a sex hormone.
Symptoms
The symptoms produced by an adrenal tumor can help determine whether the patient requires surgery. Because pheochromocytoma tumors increase adrenaline and noradrenaline levels, they cause the heart to beat faster and stronger while constricting blood vessels. This results in symptoms including rapid heartbeat, high blood pressure, sweating, headaches and anxiety. Other symptoms include abdominal pain and weight loss.
The symptoms caused by adrenocortical carcinoma tumors differ. Increased cortisol levels cause fat to accumulate in the neck and face resulting in a hump on the neck and a round face. High levels of cortisol also contribute to weight gain. Increased levels of aldosterone causes muscle cramps, weakness, increased thirst and increased urination, according to MedinePlus and the National Institutes of Health.
Criteria for Surgery
Not all adrenal gland tumors affect hormone production. Tumors that fail to produce any symptoms may only be found by chance and may not require surgical removal. The Society for Gastrointestinal and Endoscopic Surgeons reports that adrenal tumors require surgical removal when the tumor produces excess hormones, a tumor larger than four to 5 cm in diameter or a cancerous tumor.
Open Surgery
Open surgery requires doctors to make a 6-inch to 12-inch incision in either the abdomen, the back or the flank to gain access to the adrenal gland, as described by the Society for Gastrointestinal and Endoscopic Surgeons. For large tumors, those over 10 cm, or tumors suspected of being cancerous, doctors recommend open surgery, according to the University of Southern California Department of Surgery.
Minimally Invasive Surgery
Doctors can remove most benign adrenal tumors through a minimally invasive procedure known as a laparoscopic adrenalectomy. The doctors perform a laparoscopic procedure through three to four 1/4-inch to 1/2-inch incisions. This type of procedure allows patients to recover quicker, reduces postoperative pain, shortens hospital stays, reduces the incidence of scars and the risk of wound herniation, according to the Society for Gastrointestinal and Endoscopic Surgeons.
