What is an adrenal adenoma?

An adrenal adenoma is a small, non-cancerous (benign) tumor of the adrenal gland.

Most of the time it is:

• Found accidentally during scans (CT/MRI)

• Not dangerous

• Called “Incidentaloma”

Q3. Are all adrenal adenomas harmful?

No. There are two types:

1. Non-Functioning Adenoma

• Does not produce hormones

• Usually harmless

• Just observation needed

2. Functioning Adenoma

• Produces excess hormones

• Can cause illness

• Needs treatment, often surgery

Q4. What problems can a functioning adenoma cause?

Hormone Excess      Condition        Symptoms

Cortisol  : Cushing’s SyndromeWeight gain, moon face, diabetes, weakness

Aldosterone: Conn’s SyndromeHigh BP, low potassium, muscle cramps

Androgens: VirilizationExcess hair, voice change (rare)

Q5. How is adrenal adenoma diagnosed?

• CT Scan / MRI – shows size and nature

• Blood & Urine Hormone Tests

• Size matters: Tumors >4–5 cm are suspicious

Q6. When is surgery needed for adrenal adenoma?

Surgery is required if:

• Tumor produces excess hormones

• Tumor size >4–5 cm

• Suspicion of cancer

• Rapid growth

Q7. What surgery is done?

Adrenalectomy – removal of adrenal gland.

Types:

• Laparoscopic (Keyhole) Surgery – most common, faster recovery

• Open Surgery – for very large or suspicious tumors

Q8. Outcome after surgery?

• Blood pressure improves

• Hormone levels normalize

• High success rate

• Most patients recover well

PART 2 – PHEOCHROMOCYTOMA

Q1. What is pheochromocytoma?

A pheochromocytoma is a rare tumor of the adrenal gland that produces too much adrenaline (catecholamines).

It can be dangerous if not treated.

Q2. What hormones does it produce?

• Adrenaline

• Noradrenaline

These cause sudden “fight or flight” reactions.

Q3. What symptoms occur?

Classic Triad:

• Severe headaches

• Sweating

• Palpitations (fast heart)

Other symptoms:

• High blood pressure (very high or fluctuating)

• Anxiety or panic attacks

• Tremors

• Weight loss

Q4. Why is pheochromocytoma dangerous?

Because it can cause:

• Stroke

• Heart attack

• Sudden BP crisis

• Death if untreated

Q5. How is it diagnosed?

• Blood & Urine tests – high catecholamines/metanephrines

• CT Scan / MRI

• MIBG Scan (special scan in some cases)

Q6. Is biopsy done?

No. Never biopsy.
It can cause severe BP crisis.

Q7. What is the treatment?

Definitive treatment = SURGERY (Adrenalectomy)

But surgery is not done immediately.

Q8. Why preparation before surgery is important?

Because tumor releases adrenaline during surgery → dangerous BP spikes.

Pre-operative preparation includes:

• Alpha-blocker medicines (10–14 days)

• Control BP

• High-salt diet & fluids

• Sometimes beta-blockers

This makes surgery safe.

Q9. What surgery is done?

Laparoscopic Adrenalectomy is most common.

Open surgery if:

• Large tumor

• Suspected cancer

• Difficult location

Q10. What happens during surgery?

• Tumor is removed carefully

• BP is closely monitored

• Anesthesia team plays a major role

Q11. Outcome after surgery?

• BP usually normalizes

• Symptoms disappear

• Very high cure rate

• Lifelong follow-up needed in some cases

Q12. Can it be cancer?

Most are benign, but 10% can be malignant.

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ROLE OF SURGERY – SUMMARY

Adrenal Adenoma

• Surgery only if functional or large

• Excellent results

• Laparoscopic preferred

Pheochromocytoma

• Surgery is mandatory

• Requires strict pre-operative preparation

• Life-saving treatment

Final Take-Home Message

• Adrenal Adenoma – often harmless but surgery if hormones or size cause problems.

• Pheochromocytoma – rare but dangerous; surgery after proper preparation is the cure.