Adrenal masses are growths that develop in one or both adrenal glands—small endocrine organs located above the kidneys that produce essential hormones. Many adrenal masses are discovered incidentally during imaging for unrelated concerns.
While most adrenal masses are benign, some may produce excess hormones or, in rare cases, represent malignant tumors. At the Center for Endocrine Tumors and Disorders, our specialists provide comprehensive evaluation and treatment for adrenal masses. Our multidisciplinary team includes fellowship‑trained endocrine surgeons, endocrinologists, and radiologists who work together to deliver accurate diagnosis, a personalized treatment plan, and compassionate care.
What Are Adrenal Masses?
Adrenal masses are abnormal growths that arise from the adrenal cortex or medulla. These lesions vary widely in behavior—some are non‑functional and harmless, while others produce hormones or carry a risk of malignancy. Determining the nature of an adrenal mass requires careful assessment by specialists experienced in endocrine disorders.
Because many adrenal masses are found incidentally, a structured evaluation is essential to determine whether the mass is benign, functional, or potentially cancerous. Our team uses advanced imaging, hormone testing, and multidisciplinary review to guide diagnosis and treatment.
Types of Adrenal Masses
Adrenal masses can arise from different parts of the adrenal gland and vary widely in their behavior, hormone production, and potential health impact. Understanding the type of adrenal mass is essential for determining whether treatment, monitoring, or further testing is needed. Each category has distinct features that help guide diagnosis and management.
Adrenal Adenomas
Adrenal adenomas are common benign tumors that often do not produce hormones. However, some adenomas are functional and may lead to conditions such as Cushing’s syndrome or hyperaldosteronism. Identifying hormone‑producing adenomas early allows for targeted treatment and relief of symptoms.
Pheochromocytoma
Pheochromocytomas are rare adrenal tumors that produce excess catecholamines, hormones that can significantly elevate blood pressure. These tumors may cause symptoms such as headaches, palpitations, and sweating. Learn more about this condition on our Pheochromocytoma page.
Adrenocortical Carcinomas
Adrenocortical carcinoma (ACC) is a rare malignant tumor arising from the adrenal cortex. These tumors may produce hormones and often present as large masses on imaging. For more information, visit our Adrenal Cancer page.
Adrenal Myelolipoma
Adrenal myelolipomas are benign, fat‑containing lesions that typically do not produce hormones. Most are asymptomatic and discovered incidentally. Large myelolipomas, however, may require monitoring or treatment due to the risk of bleeding or discomfort.
Adrenal Metastases
The adrenal glands are a common site for metastases from cancers such as lung, breast, kidney, and melanoma. Identifying adrenal metastases is important for staging and treatment planning in patients with a history of cancer. Our team collaborates closely with oncology specialists to guide comprehensive care.
Adrenal Lymphoma
Adrenal lymphoma is a rare malignancy that may involve one or both adrenal glands. Because it behaves differently from other adrenal tumors, diagnosis and treatment require coordinated care between endocrinology, oncology, and radiology. Early recognition supports timely initiation of therapy.
Causes and Risk Factors
A number of factors can contribute to the development of adrenal masses, ranging from age‑related changes to inherited genetic conditions. While many adrenal lesions are benign, identifying underlying risk factors helps determine which patients may require closer monitoring or additional testing. Understanding these influences supports early detection and personalized care.
Adrenal masses can develop for a variety of reasons, including age‑related changes, genetic syndromes, prior cancer history, autoimmune disease, or chronic infections. While many adrenal lesions remain stable over time, others may grow, produce hormones, or require surgical treatment. Ongoing monitoring by experienced specialists ensures early detection of changes.
Genetic Syndromes Associated With Adrenal Masses
Some adrenal tumors—particularly pheochromocytomas—are linked to inherited genetic conditions such as MEN2A, MEN2B, Li‑Fraumeni syndrome, Von Hippel–Lindau disease, and Neurofibromatosis type 1. Patients with these syndromes often require lifelong surveillance. Our genetic counseling team provides evaluation and testing for individuals with hereditary risk.
Symptoms of Adrenal Masses
Symptoms of adrenal masses depend on whether the tumor produces hormones or grows large enough to affect nearby organs. Some patients experience noticeable changes in blood pressure, metabolism, or energy levels, while others have no symptoms at all. Recognizing these patterns helps guide timely evaluation and treatment.
Most adrenal masses do not cause symptoms unless they produce hormones or grow large enough to affect nearby structures. Symptoms vary depending on the type of mass and whether hormone secretion is present.
Symptoms of Hormone‑Producing Masses
- High blood pressure
- Weight gain or fat redistribution
- Muscle weakness
- Excessive sweating
- Anxiety or palpitations
- Low potassium levels
- Blood sugar changes
Symptoms of Non‑Functional or Large Masses
- Abdominal or flank discomfort
- Feeling of fullness
- Back pain
- Fatigue
Comprehensive Diagnostic Evaluation
A thorough diagnostic evaluation is essential for determining whether an adrenal mass is benign, functional, or potentially malignant. This process typically includes imaging studies, hormone testing, and multidisciplinary review to ensure an accurate diagnosis. Early and precise evaluation helps guide the most effective treatment plan.
A thorough diagnostic workup is essential for determining the nature of an adrenal mass and guiding treatment. Our team uses advanced imaging, hormone testing, and multidisciplinary review to ensure accurate diagnosis.
Imaging Studies
Imaging plays a central role in distinguishing benign from malignant adrenal lesions. CT scans, MRI, and PET imaging help evaluate adrenal morphology, density, and suspicious features. Interpretation by specialists familiar with endocrine imaging improves diagnostic accuracy and informs treatment planning.
Blood and Urine Testing
Hormone testing helps determine whether an adrenal mass is producing excess hormones. Blood and urine tests evaluate cortisol, aldosterone, catecholamines, and other hormones depending on the clinical presentation. These tests can detect subtle hormonal excess that may not be obvious from symptoms alone.
Adrenal Biopsy
Adrenal biopsy is rarely needed and is typically reserved for evaluating suspected metastatic disease. Biopsy is only performed after ruling out pheochromocytoma to avoid complications. For most primary adrenal tumors, diagnosis is made through imaging and biochemical evaluation rather than biopsy.
How Specialists Evaluate Adrenal Mass Behavior
Not all adrenal masses behave the same, and understanding their characteristics is key to determining the best course of action. Specialists assess hormonal activity, imaging features, growth patterns, and patient history to evaluate risk. This comprehensive approach ensures that each patient receives the most appropriate level of care.
Not all adrenal lesions behave the same. Determining whether a mass is functional, benign, or potentially malignant requires careful assessment of hormonal activity, imaging characteristics, growth rate, and patient history.
Indeterminate Lesions
Some adrenal masses do not clearly fit into benign or suspicious categories. These indeterminate lesions may require repeat imaging, advanced imaging analysis, or multidisciplinary review. Close monitoring helps determine whether observation or treatment is appropriate.
Bilateral Masses
Bilateral adrenal lesions may indicate genetic syndromes, metastases, infection, or lymphoma. Evaluation by a multidisciplinary team ensures accurate diagnosis and tailored treatment planning. Understanding the underlying cause is essential for guiding long‑term management.
Treatment Options for Adrenal Masses
Treatment for adrenal masses varies depending on the type of lesion, its size, hormone production, and overall risk profile. Some masses require only observation, while others benefit from medical therapy or surgical removal. Our team tailors each treatment plan to support long‑term health and symptom relief.
Treatment depends on the type, size, and behavior of the adrenal mass, as well as the patient’s symptoms and overall health. Our team develops individualized treatment plans based on comprehensive evaluation.
Observation and Monitoring
Many benign adrenal adenomas and myelolipomas do not require surgery. Monitoring may include periodic imaging, hormone testing, and clinical evaluations to track changes over time. Stable, non‑functional lesions can often be safely observed long‑term.
Medical Therapy
Medical therapy may be recommended for certain hormone‑producing tumors or when surgery is not appropriate. Treatment may include blood pressure control, hormone‑modulating medications, or oncology‑guided systemic therapy for metastatic disease. Care is tailored to the specific type and activity of the adrenal mass.
Minimally Invasive Adrenal Surgery
Surgery may be recommended for functional tumors, large masses, or lesions suspicious for cancer. Minimally invasive adrenalectomy—performed using laparoscopic or robotic techniques—offers benefits such as reduced recovery time and less postoperative discomfort. Our surgical team, including Dr. Melanie Goldfarb, specializes in advanced adrenal surgery and complex endocrine procedures. Learn more about our Endocrine Surgery Program.
Treatment for Adrenocortical Carcinoma or Adrenal Lymphoma
Aggressive adrenal cancers such as ACC or adrenal lymphoma require coordinated care between surgical oncology, endocrinology, and medical oncology. Treatment may include surgery, systemic therapy, radiation, or participation in clinical trials. Because each case is unique, individualized treatment planning is essential.
Multidisciplinary Care Approach
Managing adrenal masses often requires collaboration among multiple specialists to ensure accurate diagnosis and effective treatment. Endocrinologists, radiologists, surgeons, and oncologists each contribute expertise to guide patient care. This coordinated approach supports comprehensive evaluation and optimal outcomes.
Managing adrenal masses requires expertise across several medical specialties. Our multidisciplinary team includes endocrinologists, radiologists, surgical oncologists, medical oncologists, and urologists when needed. Coordinated evaluation ensures accurate diagnosis and effective, personalized care.
Adrenal Masses and Cancer Considerations
While many adrenal masses are benign, some may be related to primary adrenal cancers or metastases from other organs. Evaluating these possibilities is essential for determining the appropriate treatment strategy and overall prognosis. A careful review of imaging, hormone testing, and medical history helps clarify the nature of the mass.
While many adrenal lesions are benign, some are related to cancer, such as metastases or primary adrenal malignancies. Evaluation includes reviewing cancer history, advanced imaging for staging, and hormone testing. Identifying adrenal metastases is particularly important, as management may influence overall treatment strategy. For more information, visit our Adrenal Cancer page.
Frequently Asked Questions
Are adrenal masses common?
Yes. With the increased use of CT and MRI, adrenal incidentalomas are frequently discovered, especially in adults over age 50. Most are benign, but evaluation is important to determine whether treatment is needed.
Are most adrenal masses cancerous?
No. Most adrenal masses are benign, such as adenomas or myelolipomas. However, evaluation is necessary to rule out hormone production or malignancy.
When is surgery necessary?
Surgery is typically recommended when the mass produces hormones, is large, grows over time, or has suspicious imaging features. Minimally invasive adrenalectomy is often the preferred approach.
Do adrenal masses cause symptoms?
Many adrenal masses are asymptomatic, but hormone‑producing tumors can cause symptoms such as high blood pressure, weight changes, or palpitations. Large masses may also cause discomfort or fullness.
Can adrenal masses be monitored instead of treated?
Yes. Many non‑functional adrenal lesions can be safely monitored with periodic imaging and laboratory testing. Your care team will determine the appropriate follow‑up schedule.
Getting answers to your questions
You should seek evaluation from an adrenal specialist if you have an adrenal mass found on imaging, experience symptoms of hormone imbalance, have a history of cancer with a new adrenal lesion, or develop bilateral or complex adrenal findings. Early evaluation supports better long‑term outcomes.
At the Center for Endocrine Tumors and Disorders at Providence Saint John’s Health Center, patients receive comprehensive evaluation, advanced imaging review, and evidence‑based treatment recommendations from specialists dedicated to endocrine health. Our team provides compassionate, personalized care for individuals with adrenal masses and complex endocrine conditions.
If you have questions regarding adrenal masses, symptoms, or treatment, please call today. Click here to request an appointment.
