Adrenal Surgery, including Laparoscopic Adrenalectomy

Adrenal Diseases

	Pheochromocytoma
	Cushing's Syndrome
	Aldosteronoma
	Benign Adrenal Masses
	Extraadrenal pheochromocytoma and paraganglioma
	Adrenal cancer

Adrenal glands
The two adrenal glands are located on top of each kidney. Adrenal glands make hormones including adrenaline (epinephrine, norepinephrine), steroids (cortisol), aldosterone and other. Surgical removal of an adrenal gland, or adrenalectomy, is most commonly performed for a tumor located within the adrenal gland that is either producing too many hormones or is potentially cancerous. Frequently, the hormones produced by an adrenal tumor can cause high blood pressure, headaches, tremors, palpitations, or significant weight gain and other symptoms. Generally, patients are referred for an adrenalectomy after an abdominal CT scan reveals an enlarged adrenal gland.

Laparoscopic adrenalectomy
Adrenalectomy (removal of the adrenal gland) can be done either “open” (where an incision is made over the abdomen or side) or “laparoscopic” (where three to four half inch incisions are made and cameras are used to operate). With laparoscopic adrenalectomy, most patients go home within 25-72 hours with minimal pain and experience a shorter recovery time than those who have open adrenalectomy.

Adrenal masses can be either benign or malignant growths of the adrenal gland or a metastasis from another cancer. Tumors which arise from the adrenal gland can be either non-functioning or hyper-functioning (whereby normal hormones of the adrenal gland are produced in excess). The most common types of hyper-functioning tumors include the following:

Pheochromocytomas are tumors which overproduce catecholamines, like epinephrine and norepinephrine. This can result in episodic high blood pressure and attacks of headaches, sweating, palpitations, fainting spells and other symptoms. If untreated, this tumor can be lethal due to the over-production of these hormones.

Aldosteronomas are tumors which overproduce aldosterone, which causes high blood pressure and low potassium blood levels. This tumor can often go undiagnosed for long periods.

Cushing's Syndrome is often caused by an adrenal tumor overproducing glucocorticoids (steroids), resulting in abdominal obesity, high blood pressure, and other symptoms. Sometimes patients with increasing weight or obesity may harbor this disease unrecognized.

Adrenal cortical carcinoma is a rare cancer which may or may not overproduce hormones. Usually this is a fast growing tumor.

Adrenal masses are being increasingly detected in patients who undergo abdominal CT scans for unrelated reasons. When these are found, they need to be evaluated by a knowledgeable physician for mild over-function or cancer potential. If the tumor appears to be a benign non-functional small mass, surgical resection is not always necessary.