AUCNY - White Plains Maple Avenue for Robotic & Minimally Invasive Surgery

“The premier practice for robotic and minimally invasive surgery in Westchester county”

Hematuria-Blood in the Urine

Blood in the urine can be a concerning symptom for patients. You may see blood tinged urine after going to the bathroom or you may have a physician tell you that a urine test demonstrates "traces" of blood...

Kidney Stones

Blood in the urine can be a concerning symptom for patients. You may see blood tinged urine after going to the bathroom or you may have a physician tell you that a urine test demonstrates "traces" of blood...

Adrenal Mass

What is it?

The Adrenal gland is a small organ that rests on top of the kidneys. It secretes a wide array of substances that help control: blood pressure, salt and electrolyte balance, stress response hormones, glucose regulation, fat metabolism, immune system function and sex hormones. The regulation of these substances is controlled carefully by portions of the brain (hypothalamus and pituitary).

What causes adrenal masses to occur?

The adrenal glands can develop masses or tumors that can be either benign or malignant. In addition, some of these growths may secrete hormones in an abnormal amount (either too much or too little) thus producing problems with a patient’s metabolism. This can result in a number of clinical symptoms. Below are several conditions that can occur with the adrenal gland:

Adenoma: A benign (non cancerous) growth of the adrenal gland. These lesions are diagnosed by CT scan or MRI. While they do not cause cancer, they may secrete substances that cause significant clinical symptoms which are part of syndromes listed below.

Adrenal Carcinoma: A rare cancerous mass of the adrenal. This tumor may be metabolically active and cause some of the medical conditions listed below. A cancerous appearing mass on the adrenal may be identified by CT scan or MRI.

  • Cushing’s Syndrome: This results from a mass with too much corticosteroid production.
    • Symptoms:
      • Obesity
      • Diabetes
      • High blood pressure
      • Increased body hair
      • Osteoporosis
      • Psychiatric symptoms-depression
    • Treatment:

      Patients will undergo an operation to remove the abnormal mass in the adrenal (s) that is producing the corticosteroids. This can be done laparoscopically through small incisions in the abdomen. It is not uncommon that patients will require medications after the surgery to replace some of the hormones lost after the adrenal is removed. Your surgeon will likely work in conjunction with an endocrinologist.

  • Conn’s Syndrome: This results from a mass with too much aldosterone which helps balance how salt and water is processed by the kidneys.
    • Symptoms:
      • High blood pressure
      • High sodium levels in the blood
      • Low potassium levels in the blood
    • Treatment:

      Patients will undergo a minimally invasive surgery (laparoscopic) to remove the adrenal gland with the abnormal mass.

  • Pheocromocytoma: This results from an abnormally high production of catecholamines. These are substances which control blood pressure and heart rate.
    • Symptoms:
      • High blood pressure
      • Palpitations
      • Headaches
      • Sweating
      • Weight loss
    • Treatment:

      This includes careful surgical removal of the tumor. Since the tumor causes problems with blood pressure, patients require careful management of the blood pressure leading up to and during the surgery.

Metastatic Disease: Some cancers of other organ systems: breast, lung, colon, thyroid gland (neck) may spread to the adrenal gland. Almost half of cancerous appearing lesions of the adrenal gland seen on CT scan or MRI are a result of spread of another type of cancer.

How is the mass evaluated and why?

Most adrenal masses are found “incidentally” when a CT scan, MRI or ultrasound is performed to evaluate another medical condition. Over 80% of masses in the adrenal gland found incidentally on CT scan or MRI are non cancerous. As part of your evaluation, your urologist may perform blood and urine tests to evaluate if the mass is metabolically active.

How are adrenal masses treated?

After a thorough evaluation, your urologist will discuss if surgery is right for you. The decision to remove a mass in the adrenal is often based on size. If it is larger than 4-5 cm (1 ½-2 inch) then it may require surgical removal or very careful follow up. If so, most cases can be performed laparoscopically with 3-4 small half inch incision in the abdomen. In some instances, surgery may not be necessary but you may need to follow the adrenal mass with subsequent CT scans or MRI for several months or years to monitor its growth as well as regular blood tests.

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