The adrenal glands are small organs (approximately 4 centimeters long and 1 centimeter wide) located above each kidney. The adrenal glands produce a variety of important chemicals or metabolic hormones. A single adrenal gland can be removed without significant consequence to hormone levels. However, the patient with both adrenal glands removed will require adrenal hormone supplementation for the remainder of his or her life.
An adrenal mass is most commonly diagnosed as an incidental finding on a CT scan, obtained for other reasons such as abdominal pain. However, an adrenal mass can be found during the evaluation of a patient who has over-production of adrenal hormones. Hormone excess can usually be detected with special blood and urine tests. All adrenal masses warrant evaluation by a specialist.
Not all adrenal masses require removal. If the growth is small (less than 3 centimeters), benign-appearing on CT scan or MRI, asymptomatic, and nonfunctioning (does not produce excess hormones), observation with regular CT scans for two years may be reasonable. However, adrenal masses suspected of cancer or hormone production are usually best treated with surgical removal.
When adrenal gland removal is needed, a laparoscopic method is almost always preferred. Laparoscopic adrenalectomy uses several small “button-hole” incisions to remove the gland. This method reduces surgical risk because of the increased visualization and precision associated with laparoscopic surgery in experienced hands. Avoidance of a large flank (rib cage) incision dramatically speeds recovery.
Q: What information should I bring to my first office visit with Dr. Scott Miller?
A: Please bring relevant x-ray films (or computer disks) and any pertinent laboratory, radiology, and pathology reports. Completing our patient information forms (available on our website) prior to your arrival will help inform Dr. Scott Miller regarding your medical history, medications and allergies.
Q: How do I know if my adrenal mass is a cancer?
A: Most adrenal masses are not cancerous. A CT scan or MRI may help reveal this information. Although needle biopsy is sometimes performed, removal is often best for accomplishing both diagnosis and treatment at the same time.
Q: What tests do I need prior to making a treatment choice?
A: Some special blood and urine tests may be necessary to help determine if the adrenal mass is producing any abnormal chemicals that are released into the blood stream.
Scott D. Miller, MD has some of the most extensive experience in the Southeast with laparoscopic adrenalectomy. He is able to apply this technique to tumors that are cancerous, very large, or highly productive of abnormal hormones. Unlike most surgeons, he usually uses a “retroperitoneal” method of removal which can further lessen the risk and recovery of the surgery.
Most adrenal masses are small and pose little threat to a patient. Occasionally it can be difficult to determine the potential harm from an adrenal tumor. Since laparoscopic adrenalectomy is minimally invasive, sometimes surgical removal is the only way to make the diagnosis.