Dr. Haneen AlBoosta — Consultant General, Endocrine & Laparoscopic Surgeon
Dr. Haneen AlBoosta — Consultant General, Endocrine & Laparoscopic Surgeon in Bahrain
Most adrenal masses are found by chance on a scan of the abdomen, and the majority are benign and non-functioning. Assessment answers two questions: does the mass produce excess hormones, and are its size and imaging features reassuring? When both answers are reassuring, monitoring is usually enough. Adrenal surgery is considered for hormonally active tumours, larger or suspicious lesions, or a mass that grows on follow-up.
You have one adrenal gland above each kidney. They produce cortisol, aldosterone and adrenaline — hormones that influence the body's stress response, salt and water balance, and blood pressure.
A lump in an adrenal gland is common and is usually discovered incidentally during a CT scan carried out for another reason. Finding one does not mean cancer and does not mean an operation is needed; it means a structured assessment is needed.
Adrenalectomy is discussed when the mass is hormonally active, when it is large or has features on imaging that are not reassuring, when it grows during follow-up, or when a phaeochromocytoma is confirmed.
Where the case is suitable, the operation can often be performed laparoscopically, with small incisions and a quicker recovery. Larger or more complex lesions may require a different surgical approach.
Preoperative endocrine preparation is essential rather than routine. In phaeochromocytoma and primary aldosteronism, specific medication is started beforehand to control blood pressure and correct electrolytes, which makes the operation safer.
After surgery, blood pressure and hormone levels are monitored. Depending on the type of lesion, some patients need temporary hormone replacement while the remaining gland recovers.
No. Many adrenal masses are small, non-functioning and benign on imaging, and are safely monitored with repeat scans and blood tests.
An adrenal mass discovered unexpectedly on a scan done for another reason. The first steps are checking whether it produces hormones and whether its imaging features are reassuring.
Through targeted tests: cortisol and suppression testing, the aldosterone-to-renin ratio, and plasma or urinary metanephrines, alongside blood pressure and potassium.
An adrenal tumour that releases adrenaline-type hormones. It can cause episodes of high blood pressure, palpitations, sweating and headache, and needs careful medical preparation before any operation.
No. The large majority are benign. Malignant adrenal tumours are uncommon, and the risk is judged from size, imaging characteristics and medical history.
For hormonally active tumours, confirmed phaeochromocytoma, larger or suspicious lesions, or a mass that clearly grows during follow-up.
A complete hormonal work-up, up-to-date CT or MRI, assessment of blood pressure and electrolytes, and specific medical preparation for functioning tumours.
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Reviewed by Dr. Haneen AlBoosta, Consultant General & Endocrine Surgeon. This page is updated periodically to remain consistent with current medical references and international guidelines. It is intended for general education and does not replace an individual medical consultation, examination or treatment plan.