Treatment of Adrenal Incidentaloma:
Management of an incidentally found adrenal mass in a patient without a known primary malignancy will depend upon the size of the mass, its characteristics on the CT or MRI scan, and whether hormonal tests indicate that the tumor is producing excessive adrenal hormones.
The two options for treating adrenal incidentaloma are:
- Monitoring its appearance with a series of CT or MRI scans, or
- Removing the adrenal mass with minimally invasive surgery, usually laparoscopically. It typically involves removal of the mass and the adrenal gland (adrenalectomy). In select cases, removal of only the tumor may be recommended (partial adrenalectomy). This surgery may be done through a single small incision in the abdomen (Single Site laparoscopic surgery) or through 3-4 small keyhole incisions. Robotic surgery may also be recommended by your surgeon. If the lesion is large and/or looks suspicious on the CT or MR imaging, the mass is secreting excessive adrenal hormones. Surgery recovery will typically require a 1-2 day hospitalization and 10-14 day recovery period.
Treatment of Adrenal Cushing's Syndrome:
Treatment of adrenal tumors that cause Cushing's disease include laparoscopic surgery and possible medication to reduce the production of cortisol.
Treatment of Primary Hyperaldosteronism/Conn's Syndrome:
Treatment of an aldosterone producing tumor involves monitoring and replacing serum potassium levels, and laparoscopic adrenal removal or partial adrenalectomy. Along with recovery from surgery, you will see your primary doctor for blood pressure and serum potassium monitoring. Your blood pressure may normalize or you may require blood pressure medication after surgery.
Treatment of Adrenal Pheochromocytoma:
The preferred treatment is removal of these functional adrenal tumors surgically. Most cases are done through minimally invasive approaches. Medical treatment is a crucial part of treatment prior to the adrenal surgery in order to suppress effects of the excessive hormone secretion.
Treatment of Metastasis of Primary Malignancy to the Adrenal Gland:
The treatment of metastatic lesions of the adrenal gland depend upon the primary malignancy. Management is usually dictated by the physician treating the primary malignancy. It may center upon medical management with chemotherapy or other medications, or possibly surgical excision.