Adrenal Cancer

Adrenal cancer is a malignant tumor that arises in the adrenal glands. Like other cancers, adrenal cancer cells can invade nearby organs or spread (metastasize) to distant sites through the blood vessels or lymphatic system.

Adrenal cancers are broadly classified as functional (hormone-producing) or non-functional (non–hormone-producing).

• Functional adrenal cancers cause symptoms depending on the excess hormone secreted.
• Non-functional adrenal cancers do not secrete hormones and may remain asymptomatic until they grow large or are discovered incidentally during imaging for other reasons.

Occasionally, adrenal tumors may produce unusual substances not typically secreted by the adrenal glands, leading to atypical symptoms.

Non-functional tumors (21–50%)

Often asymptomatic in early stages; many are found incidentally during health checkups or imaging for unrelated conditions.

Functional tumors (50–70%)

Cause symptoms depending on the hormone secreted.

• Cortisol overproduction → Cushing’s syndrome: round “moon” face, central obesity, edema, acne, hypertension, diabetes, and muscle wasting.
• In women: menstrual irregularities, hirsutism (excess hair growth), infertility, or other hormone-related changes.

Local tumor effects

As tumors grow, they may cause abdominal pain, fullness, bloating, or indigestion.

Metastatic spread

Enlarged lymph nodes may be felt, and symptoms vary depending on whether the cancer has spread to the liver, lungs, bones, or other organs.

The exact causes of adrenal cancer are not well understood. While most adrenocortical carcinomas are sporadic (not inherited), some are linked to genetic syndromes, especially in children:

• Li-Fraumeni syndrome (LFS) – autosomal dominant cancer predisposition syndrome.
• Beckwith-Wiedemann syndrome (BWS) – congenital disorder associated with overgrowth and increased risk of childhood cancers.
• Multiple endocrine neoplasia type 1 (MEN1, Wermer syndrome) – genetic disorder causing tumors in the parathyroid, pancreas, and pituitary glands.
• Familial adenomatous polyposis (FAP) – inherited disorder that increases risk of colon polyps and several cancers, including adrenal cancer.

Other potential contributing factors:

• High-fat diet
• Smoking
• Physical inactivity
• Environmental exposure to carcinogens

People with a family history of adrenal, pituitary, parathyroid, or pancreatic tumors should discuss genetic counseling with their physician.

There is no proven method to prevent adrenal cancer. However, avoiding modifiable risk factors such as smoking, high-fat diet, and environmental carcinogen exposure, along with maintaining an active lifestyle, may help reduce risk.