You can get adrenal cancer in one or both adrenal glands.

Types of adrenal gland cancer

There are three main types of adrenal cancer. Each starts in a different area of your adrenal gland:

• Adrenocortical carcinoma (ACC) This is the most common type of adrenal cancer. It forms in the outer layer of your adrenal gland (the cortex). Your cortex makes steroid hormones that control elements like metabolism, blood pressure, body shape, and hair growth. Another name for adrenocortical carcinoma is adrenal cortex cancer..

• Neuroblastoma : Neuroblastomas form in nerve cells, so they can affect many different parts of your body. However, about one-third form in the inner part of your adrenal gland (the medulla). The medulla makes epinephrine and norepinephrine. These chemicals help control your sympathetic nervous system, which regulates things like sweating, heart rate, and blood pressure. Adrenal neuroblastomas usually affect infants and children under the age of 10.

• Pheochromocytoma. This adrenal gland cancer starts in the center of your medulla, usually in the cells that produce adrenaline. Adrenaline helps regulate your blood pressure and heart rate.

How common is adrenal gland cancer?

Adrenal gland cancer is rare, affecting about 200 people in the United States every year.

Symptoms and Causes

What are the symptoms of adrenal cancer?

Adrenal cancer affects everyone differently. Some people develop pain if the tumor grows and presses on nearby organs. Others may notice symptoms based on the extra hormones the tumor releases.

General adrenal cancer symptoms may include:

• Abdominal pain.

• Back pain.

• Feeling of fullness in your belly.

• Muscle cramps.

• Weakness.

• Headaches.

Hormone-specific adrenal cancer symptoms might include:

• Excess facial or body hair (hirsutism).

• Newly elevated blood sugar (diabetes).

• High blood pressure.

• Low potassium (hypokalemia).

• Unexplained weight loss.

• Unexplained weight gain.

• Fast heartbeat.

• Enlarged breasts.

• Enlarged penis or clitoris.

• Low sex drive (low libido).

• Anxiety.

• Panic attacks.

In some cases, adrenal gland tumors don’t cause any symptoms.

Metastatic adrenal cancer symptoms

People with metastatic adrenal cancer (cancer that spreads from your adrenal glands to other parts of your body) might develop more severe symptoms as the disease progresses. Possible Stage 4 adrenal cancer symptoms include:

• Nausea and vomiting.

• Bloating.

• Fatigue.

• Fever.

• Confusion.

• Loss of appetite.

What causes adrenal cancer?

Healthcare providers don’t know what causes most adrenal gland cancers. They know that mutations in the DNA can cause cells in your adrenal gland to change, grow, and become cancerous. But they don’t know exactly why these DNA mutations happen.

Some people inherit a gene mutation from a biological parent, which increases their risk of adrenal cancer. Others may develop adrenal gland cancer due to exposure to certain cancer-causing substances. But in the majority of cases, these DNA mutations seem to happen for no apparent reason.

Adrenal cancer risk factors

A risk factor is something that increases your chance of developing a certain cancer or disease. It doesn’t mean that you’ll get the disease, but it helps you know you’re at risk.

Possible environmental risk factors for adrenal cancer include:

• Smoking.

• Exposure to certain chemicals like asbestos and radon.

• Prior radiation therapy to your abdomen, where your adrenal glands are located.

While most adrenal cancers occur for no apparent reason, about 15% of people who develop adrenal tumors have a genetic disorder. This is most common in children. Genetic disorders associated with adrenal gland cancer include:

• Beckwith-Wiedemann syndrome.

• Von Hippel-Lindau syndrome.

• Li-Fraumeni syndrome.

• Familial adenomatous polyposis (FAP).

• Neurofibromatosis type 1.

• Multiple endocrine neoplasia (MEN).

• Carney complex.

• Lynch syndrome.

Diagnosis and Tests

How is adrenal cancer diagnosed?

Your healthcare provider may suspect cancer in your adrenal glands based on your specific symptoms, such as excessive hair growth or unexplained weight changes. But sometimes, providers find adrenal tumors after taking a CT (computed tomography) scan or MRI (magnetic resonance imaging) for other reasons.

During a visit with your healthcare provider, they’ll:

• Perform a physical examination.

• Review your medical history.

• Ask about your symptoms.

• See if you have any known risk factors for adrenal cancer.

• Review your family history of cancer.

What tests can help diagnose adrenal cancer?

After your exam, your healthcare provider will run additional tests to confirm your diagnosis or rule out other conditions. These tests may include:

• Blood tests.

• Urinalysis (urine tests).

• Imaging tests.

Adrenal cancer staging

Healthcare providers use a cancer staging system to diagnose adrenal cancer. Staging tells you the size and location of the tumor and whether it has metastasized (spread to other areas of your body).

In general, the higher the number, the more advanced the tumor:

• Stage 1: The tumor measures 5 centimeters or less and hasn’t spread outside of your adrenal gland.

• Stage 2: The tumor measures more than 5 centimeters and hasn’t spread outside of your adrenal gland.

• Stage 3: The cancer is in your adrenal gland and has spread to surrounding tissues or nearby lymph nodes.

• Stage 4: The cancer is in your adrenal gland and has spread to distant areas of your body, such as your lungs or liver.

Staging systems can be complex. If you have specific questions about your diagnosis, you should talk to your healthcare provider.

Diagnosis and Tests

How is adrenal cancer diagnosed?

Your healthcare provider may suspect cancer in your adrenal glands based on your specific symptoms, such as excessive hair growth or unexplained weight changes. But sometimes, providers find adrenal tumors after taking a CT (computed tomography) scan or MRI (magnetic resonance imaging) for other reasons.

During a visit with your healthcare provider, they’ll:

• Perform a physical examination.

• Review your medical history.

• Ask about your symptoms.

• See if you have any known risk factors for adrenal cancer.

• Review your family history of cancer.

What tests can help diagnose adrenal cancer?

After your exam, your healthcare provider will run additional tests to confirm your diagnosis or rule out other conditions. These tests may include:

• Blood tests.

• Urinalysis (urine tests).

• Imaging tests.

Adrenal cancer staging

Healthcare providers use a cancer staging system to diagnose adrenal cancer. Staging tells you the size and location of the tumor and whether it has metastasized (spread to other areas of your body).

In general, the higher the number, the more advanced the tumor:

• Stage 1: The tumor measures 5 centimeters or less and hasn’t spread outside of your adrenal gland.

• Stage 2: The tumor measures more than 5 centimeters and hasn’t spread outside of your adrenal gland.

• Stage 3: The cancer is in your adrenal gland and has spread to surrounding tissues or nearby lymph nodes.

• Stage 4: The cancer is in your adrenal gland and has spread to distant areas of your body, such as your lungs or liver.

Staging systems can be complex. If you have specific questions about your diagnosis, you should talk to your healthcare provider.