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The adrenal glands are two small triangular glands weighing 7-8 grams, located above each kidney. The adrenal gland consists of an outer part, called the cortex and an inner part, called the marrow.


The adrenal glands produce and secrete important hormones into the bloodstream. The cortex produces mineralocorticoids (mainly aldosterone), glucocorticoids (mainly cortisol) and androgens. Adrenaline and noradrenaline are produced in the marrow. Hormones secreted by the adrenal glands play an important role in regulating various body functions.


Adrenal tumors are divided into the following categories:


Α. Primary adrenal cancer.

It is a rare but very dangerous cancer. It can emerge in families with rare genetic syndromes. It grows and spreads to all parts of the body rapidly. Patients usually show no symptoms, which makes early diagnosis difficult. Pain in the back or laterally in the abdomen may occur.


Β. Metastatic adrenal cancer.

Kidney cancer, melanoma, lung cancer and lymphoma usually give metastases into the adrenal glands.


C. Non-functional tumors (i.e. tumors that are not associated with hormone overproduction)

They are usually accidental findings during imaging examinations for other reasons and for this reason they were called adrenal incidents (incidentalomas). As for their biological behavior, it can be benign or malignant.
An important factor in assessing the likelihood of malignancy is imaging (CT or MRI). In terms of tumor size, the larger it is the more suspicious it is for malignancy, as studies have shown that in formations less than 4cm in diameter the malignancy reaches 2%, in those with a diameter of 4-6cm it reaches 6% and in those with a diameter over 6cm the rate of primary cancer is 25%.


D. Functional (hypersecreting hormones) tumors of the marrow or adrenal cortex.

  1. Aldosteronoma (Conn Syndrome)

    It concerns a solitary benign tumor (adenoma) of the cortex of the organ, which leads to hypersecretion of aldosterone. Aldosterone belongs to the class of mineralocorticoids and regulates potassium and sodium levels in the blood. Increased production results in sodium retention in the body, with consequent water retention and increased blood pressure. The diagnosis is made by hematological and imaging test (CT ή MRI).

  2. Pheochromocytoma

    It is a rare tumor of the adrenal marrow and in most cases is benign, while it can emerge on both sides.

    It originates from a class of cells called chromophiles and because these cells are found throughout the body, the tumor can also appear in extra-adrenal structures such as the heart, cervix, bladder and spine. In some cases they appear familial (i.e. they are inherited due to gene mutations in members of the same family).

    Symptoms include high blood pressure, hypertensive crises, tachycardia, sweating, headaches, restlessness and tremor.

    The diagnosis is made by laboratory blood and urine tests and imaging tests (CT and MRI).

  3. Cushing's Syndrome (Adenoma with cortisol hypersecretion)

    Cortisol is responsible for important organic functions and essential for life. But its hypersecretion has many negative effects on the body.

    Most patients develop symptoms that worsen over time. Gradual weight gain is the most common symptom. Fat deposition is typical on the face, neck, torso and abdomen while the limbs are usually thin and weak. Menstrual disorders, hhypertrichosis, oily skin and acne can occur in women. Hypercotizolaemia also leads to osteoporosis and diabetes. Many times psychological symptoms coexist. Diagnosis requires a blood test, urine test and imaging test (CT orMRI).

  4. Tumors with hypersecretion of androgens that cause androgenital syndrome.

    In terms of treatment, the treatment of choice for all malignant functional or non-functional adrenal tumors is adrenalectomy, which in recent years is performed laparoscopically or robotically with immediate recovery, excellent postoperative course and rapid return to work without large scars.

    Adrenal cancer is usually treated with open transabdominal surgery because it requires the removal of other organs as well as lymph nodes, but without excluding laparoscopic or robotic treatment.

    Solitary adrenal metastases are treated surgically and very rarely with radiotherapy or chemotherapy. The operation is performed laparoscopically or robotically, avoiding the dispersion of the disease.