adrenal cancer
Meaning of adrenal cancer: Cancer starting in the adrenal glands is rare, while cancer found in them is not, because they attract spread from elsewhere.
Definition of adrenal cancer
Adrenal cancer is a malignant growth arising in one of the two small hormone-making glands capping the kidneys. Tumors of the outer layer are adrenocortical carcinomas and frequently pour out cortisol or sex hormones. Tumors of the inner core are pheochromocytomas, which release adrenaline and are usually not malignant. Both are uncommon, and most cancer detected in an adrenal gland arrived there from another organ.
What do the two layers do?
An adrenal gland is really two organs stacked together. The outer rind makes steroid hormones: cortisol, which governs the response to stress and the handling of sugar; aldosterone, which controls salt, water and therefore blood pressure; and a supply of weak sex hormones. The inner core is modified nerve tissue and makes adrenaline, released in bursts through the sympathetic nerves. Tumors of the two parts share nothing except an address, and they announce themselves in completely different ways.
| Layer | Hormones made | Tumor arising there |
|---|---|---|
| Cortex, the outer rind | Cortisol, aldosterone, weak sex hormones | Adrenocortical adenoma or carcinoma |
| Medulla, the inner core | Adrenaline and noradrenaline | Pheochromocytoma |
| Either | None added | A deposit spread from a distant cancer |
How does a hormone-making tumor announce itself?
By its hormone rather than by its size. An adrenocortical carcinoma flooding the body with cortisol produces weight piling on around the trunk, a rounded face, thinned skin with purple stretch marks, wasted muscle, raised blood sugar and raised pressure. One making androgens instead causes deepening of the voice and unwanted hair growth in women, or early puberty in a child. A core tumor gives a quite different picture of pounding headache, sweating, palpitations and surges of pressure, and the skin during an attack classically turns pale rather than flushed.
Why is malignant pheochromocytoma an outdated label?
Because the microscope cannot separate the harmless from the dangerous in these tumors. No pattern of cells reliably predicts behavior, so malignancy is recognized only when tumor turns up where this tissue does not naturally occur, such as bone, liver or lymph nodes. Current classification therefore treats every one of them as carrying some capacity to spread, and describes the ones that do so as metastatic rather than malignant. Alongside all of this sits a far more common finding: a small nodule noticed by chance when the abdomen is scanned for another reason, which in most cases is harmless and makes no hormone at all.
Also known as
Used in a sentence
Imaging and hormone testing were used to distinguish adrenal cancer from a benign nodule.
Good to know
Most masses discovered in an adrenal gland on scanning are harmless nodules making no hormone, and among true cancers found there, deposits spread from another organ far outnumber tumors that began in the gland.
Word origin
Where “adrenal cancer” comes from
Adrenal joins the Latin ad, meaning toward or beside, with renes, the kidneys, describing where the glands sit.