Understanding Adrenal Nodules
Photo credit: Journal of Clinical and Translational Endocrinology: Case Reports
Adrenal nodules are abnormal growths found in the adrenal glands, small glands located above the kidneys that produce important hormones such as cortisol, aldosterone, and adrenaline. These nodules are often discovered incidentally during imaging tests conducted to investigate conditions other than adrenal-related reasons, such as ultrasounds, CT scans, or MRIs.
Adrenal nodules can be either benign (non-cancerous) or malignant (cancerous). Fortunately, most adrenal nodules are benign and non-functioning. However, occasionally, it can affect hormone production and lead to health complications. Depending on the type and impact of the nodule, different treatment approaches may be required.
Types of Adrenal Nodules
- Non-functioning Adenomas: These are the most common adrenal nodules. They do not produce hormones and are typically benign. In many cases, they require no treatment unless they grow large enough to cause symptoms.
- Functioning Nodules: These nodules secrete hormones and can cause disorders like Cushing’s syndrome (excess cortisol), Conn’s syndrome (excess aldosterone), or pheochromocytoma (excess adrenaline).
- Adrenal Cysts: Fluid-filled sacs that are usually benign but can sometimes grow large, causing discomfort.
- Adrenal Carcinomas: These rare nodules are cancerous and may grow rapidly, posing significant health risks as they can spread to other parts of the body.
Symptoms of Adrenal Nodules
Most non-functioning adrenal nodules are asymptomatic, making them difficult to detect without imaging. However, functioning nodules can produce a variety of symptoms based on the hormones they secrete:
- High Blood Pressure: Especially in cases of Conn’s syndrome.
- Muscle Weakness: Often due to electrolyte imbalances from excessive aldosterone.
- Abnormal Weight Gain or Loss: Hormonal imbalances can lead to unintentional changes in body weight.
- Mood Changes: Hormone-secreting nodules may cause mood swings, fatigue, or anxiety.
- Skin Changes: Conditions like Cushing’s syndrome may cause thinning skin, easy bruising, or purple stretch marks.
Causes of Adrenal Nodules
Adrenal nodules can be a result of a combination of the following factors:
- Benign Tumors (Adenomas): These are the most common cause of adrenal nodules and are usually non-cancerous.
- Hormonal Overproduction: Some nodules secrete excess hormones like cortisol, aldosterone, or adrenaline, leading to conditions like Cushing’s syndrome or hyperaldosteronism.
- Adrenal Cancer: Although rare, malignant adrenal tumours can form nodules.
- Genetic Factors: Some familial syndromes, such as multiple endocrine neoplasia, can increase the likelihood of developing adrenal nodules.
Diagnosis of Adrenal Nodules
At Harmony Thyroid, Endocrinology and Diabetes Centre, Dr Vikram Sonawane, our experienced endocrinologist in Singapore, will conduct a thorough assessment that usually includes:
- Imaging Tests: CT scans or MRI imaging studies to detect the size, location, and characteristics of the nodule.
- Hormonal Evaluation: Blood and urine tests are used to measure hormone levels and determine whether the nodule is secreting excess hormones.
- Biopsy: A biopsy may be performed to assess the nodule for malignancy, especially when imaging and hormonal tests are inconclusive.
Managing Life with Adrenal Nodules
Living with adrenal nodules requires regular monitoring and communication with your doctor. For non-functioning nodules, follow-up imaging may be necessary to track growth. If the nodule is hormone-secreting, you may need medications and lifestyle adjustments to manage symptoms and maintain hormone balance.
Adrenal nodules are often benign and non-symptomatic, but early detection and proper management are essential to prevent potential complications.
If you have been diagnosed with adrenal nodules or are experiencing symptoms, book an appointment with Harmony Thyroid, Endocrinology and Diabetes Centre. Our Senior Consultant Endocrinologist, Dr Vikram will conduct a thorough evaluation and recommend a personalised treatment plan.
