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An adrenal tumor or adrenal mass [2] is any benign or malignant neoplasms of the adrenal gland, several of which are notable for their tendency to overproduce endocrine hormones. Adrenal cancer is the presence of malignant adrenal tumors, and includes neuroblastoma , adrenocortical carcinoma and some adrenal pheochromocytomas .
An adrenocortical adenoma or adrenal adenoma is commonly described as a benign neoplasm emerging from the cells that comprise the adrenal cortex.Like most adenomas, the adrenocortical adenoma is considered a benign tumor since the majority of them are non-functioning and asymptomatic.
Primary aldosteronism (hyporeninemic hyperaldosteronism) is most often caused by bilateral idiopathic (micronodular) adrenal hyperplasia (almost 70% of cases) [4] and adrenal adenoma (Conn's syndrome) (about 30% of cases). [4] These cause hyperplasia of aldosterone-producing cells of the adrenal cortex resulting in primary hyperaldosteronism.
Although adrenal incidentalomas are common, they are not commonly cancerous - less than 1% of all adrenal incidentalomas are malignant. [2] The first considerations are size and radiographic appearance of the mass. Suspicious adrenal masses or those ≥4 cm are recommended for complete removal by adrenalectomy.
The majority of bilateral tumours can be distinguished according to size and aspect of the nodules: primary pigmented nodular adrenocortical disease, which can be sporadic or part of Carney complex, and primary bilateral macro nodular adrenal hyperplasia. [citation needed] Metastasis is most commonly to the liver and lung. [15]
MRI scan T1 with fat saturation - adrenal adenoma. Adrenal adenomas are common, and are often found on the abdomen, usually not as the focus of investigation; they are usually incidental findings. About one in 10,000 is malignant. Thus, a biopsy is rarely called for, especially if the lesion is homogeneous and smaller than 3 centimeters.
Incidences and prognoses of adrenal tumors, [7] with myelolipoma at right. Myelolipomas are rare. They have been reported to be found unexpectedly at autopsy in 0.08% to 0.4% of cases (i.e.: somewhere between 8 per 10,000 and 4 per 1,000 autopsies). They most commonly occur in the adrenal gland, and comprise about 8% of all adrenal tumours. [8]
Congenital adrenal hyperplasia due to 21-hydroxylase deficiency; Other names: 21-OH CAH: CT scan shows enlarged adrenals with masses consistent with congenital adrenal hyperplasia due to 21-hydroxylase deficiency (image credit: NICHD/A. Mallappa, D. Merke) Specialty: Endocrinology Symptoms: Androgen excess and corticosteroid deficiencies: Frequency