Anatomy and Physiology
The adrenal glands are triangular, orange glands which lie just above each kidney. Each gland is ½ inch tall and 3 inches wide, weighing 4 - 5 grams. The glands produce a variety of hormones including epinephrine, aldosterone, norepinephrine, and cortisol.
Adrenal masses can be either benign or malignant growths of the adrenal gland or a metastasis from another tissue. Tumors which arise from the adrenal gland can be either non-functioning or functioning (where they overproduce one or more of the hormones that the gland normally produces). Several types of adrenal tumors include:
Pheochromocytomas are slow-growing tumors which overproduce catecholamines like epinephrine and norepinephrine. This can result in high blood pressure and episodic attacks of headaches, sweating, palpitations, and other symptoms.
Aldosteronomas are tumors which overproduce aldosterone, which causes high blood pressure and low potassium levels.
Cushing’s syndrome is sometimes caused by an adrenal tumor overproducing glucocorticoids resulting in abdominal obesity, high blood pressure, and other symptoms.
Adrenal cortical carcinoma is a rare cancer which may or may not overproduce hormones.
An adrenalectomy (removal of one adrenal gland) can be done either “open” (where a long incision is made over the abdomen or side) or “laparoscopic” (where 3 to 4 small incisions are made, each ½ to 1 inch in length). Laparoscopic adrenalectomy is our preferred approach to most adrenal masses. This approach allows a short stay in the hospital (generally patients go home one to two days after surgery) and a shorter recovery.
We have recently introduced a new posterior, retroperitoneoscopic technique allowing us to avoid abdominal incisions and shorten operative times. Vanderbilt's Endocrine Surgery Center is one of only a few American centers to offer this technique.
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