What Are the Symptoms of Adrenal Adenoma?

Obesity, muscle weakness, severe fatigue and high blood pressure are just a few of the symptoms of a functioning adrenal adenoma (benign adrenal gland tumor). Many of these tumors cause no symptoms -- these are designated “non functioning” as they don’t affect hormone levels.

Adrenal adenomas are non-cancerous (benign) tumors on the adrenal gland that occur when cells of the adrenal gland grow out of control. Most of the time they do not cause symptoms but some may produce hormones in excess of what the adrenal glands typically produce that require treatment.

What Are Symptoms of Adrenal Adenoma?

Most adrenal adenomas are considered “nonfunctioning,” which means they do not produce hormones and usually do not cause symptoms. 

If adrenal adenomas become "functioning" or "active" and secrete excess hormones, they can cause conditions such as Cushing's syndrome, primary aldosteronism, or virilization.

Cushing's syndrome occurs when adrenal adenomas release excess levels of the hormone cortisol. Symptoms of Cushing’s syndrome include: 

• Upper body obesity
• Severe fatigue 
• Muscle weakness
• High blood pressure (hypertension)
• Backache
• High blood sugar (hyperglycemia)
• Easy bruising
• Bluish-red stretch marks on the skin
• Increased facial and body hair growth in women
• Irregular or missed menstrual periods 

Primary aldosteronism (also called Conn syndrome) occurs when the adrenal gland produces too much of the hormone aldosterone. Symptoms of primary aldosteronism may include:

• High blood pressure (hypertension)
• Fatigue
• Headache
• Muscle weakness
• Numbness and paralysis that comes and goes

Benign cortisol-secreting adenomas can also produce small amounts of androgens (steroid hormones, such as testosterone) that can cause an increase in masculine characteristics (virilization) with symptoms such as:

• Increased facial and body hair (hirsutism)
• Deepening of the voice
• Increased muscularity

The cause of most adrenal adenomas is unknown. 

Most adrenal adenomas are not inherited but they occasionally occur in people with certain genetic syndromes such as:

• Multiple endocrine neoplasia, type 1 (MEN1)
• Familial adenomatous polyposis (FAP)

In addition to a physical exam and patient’s medical history, tests used to diagnose adrenal adenomas include: 

• Computed tomography (CT scan)
• Magnetic resonance imaging (MRI scan)
• Positron emission tomography (PET scan)
• Biopsy of the tumor 
• Laboratory tests to check levels of certain hormones in the blood or urine 

Genetic testing may be used for people with an inherited condition that predisposes them to adrenal adenomas such as multiple endocrine neoplasia, type 1 (MEN1) and familial adenomatous polyposis (FAP).

Treatment for adrenal adenomas depends on whether or not the adenoma is "functional" (releasing hormones). If the tumor is “nonfunctioning,” meaning it is not releasing hormones, it may not require treatment, though regular monitoring may be recommended to detect if it starts to produce hormones. 

If the adrenal adenoma is “functional” the treatment is usually surgical removal of the affected adrenal gland. This usually resolves medical conditions that may be caused by elevated adrenal hormones (i.e., primary aldosteronism, Cushing's syndrome). 

Other treatments for adrenal adenomas include medications to block the function or lower the levels of the overproduced hormones.

If adrenal adenomas become "active" or "functioning" and produce excess hormones, this can lead to complications such as: 

• Cushing's syndrome 
• Primary aldosteronism (also called Conn syndrome)
• Increased masculine characteristics (virilization)