UROLOGY · CONDITIONS
Adrenal Tumors
Benign or malignant adrenal gland tumours causing hormonal excess or discovered incidentally on imaging , requiring expert biochemical workup before surgical removal.
ABOUT THIS CONDITION
What is Adrenal Tumors?
Adrenal tumours include functioning adenomas (Conn's , aldosteronoma, Cushing's , cortisol-secreting), phaeochromocytoma (catecholamine excess), adrenocortical carcinoma (ACC), and metastatic deposits. They may be found incidentally (adrenal incidentaloma) or through symptoms of hormonal excess. All require biochemical evaluation before any intervention, as unoperated phaeochromocytoma can cause fatal hypertensive crisis under anaesthesia. Dr. Vipin performs laparoscopic or robotic adrenalectomy for all adrenal tumours, with thorough pre-operative biochemical preparation , especially alpha-blockade for 10–14 days before phaeochromocytoma surgery , ensuring patient safety and complete oncological removal.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Adrenal adenoma , most common cause of incidentaloma
- Primary aldosteronism (Conn's) , zona glomerulosa adenoma
- Cushing's syndrome , ACTH-independent cortisol excess from adenoma
- Phaeochromocytoma , chromaffin cell catecholamine tumour
- Adrenocortical carcinoma (ACC) , malignant, usually large (>4 cm)
- Metastatic deposits , lung, breast, melanoma, renal primary
CLINICAL DETAILS
Key Facts
ALWAYS exclude phaeochromocytoma biochemically before surgery , crisis can be fatal.
10–14 days of phenoxybenzamine before phaeochromocytoma surgery , mandatory patient safety measure.
Aldosterone-to-renin ratio screens for primary aldosteronism. Adrenal venous sampling lateralises the tumour.
All incidentalomas >1 cm require biochemical workup and size-based surveillance or surgery
Laparoscopic adrenalectomy for tumours <6–8 cm , gold standard minimally invasive approach.
Large (>4 cm) or malignant-appearing masses require open adrenalectomy for en bloc R0 resection.
HOW WE TREAT IT
Treatment Approach
Laparoscopic Adrenalectomy
The adrenal gland is removed laparoscopically through small port incisions , the gold standard for benign and selected malignant adrenal tumours, offering minimal blood loss, 1–2 day hospital stay, and rapid recovery.
- 1
Biochemical Workup
24-hour urinary metanephrines, aldosterone-to-renin ratio, and overnight dexamethasone suppression test performed for all adrenal masses , phaeochromocytoma excluded first.
- 2
Pre-operative Preparation
Alpha-blockade with phenoxybenzamine for 10–14 days before phaeochromocytoma surgery. Beta-blockade added after alpha-blockade established. IV fluids pre-operatively.
- 3
Laparoscopic Adrenalectomy
Transperitoneal or retroperitoneoscopic approach. Adrenal gland and tumour removed in a specimen bag. Adrenal vein ligated first for phaeochromocytoma.
- 4
Post-operative Monitoring
Blood pressure and glucose monitored closely post-adrenalectomy. Steroid replacement for bilateral or post-Cushing's surgery. Histopathology confirms diagnosis.
AVAILABLE TREATMENTS
Treatment Options
Laparoscopic Adrenalectomy
Gold standard minimally invasive adrenalectomy , small incisions, 1–2 day hospital stay, rapid recovery for most adrenal tumours.
Robotic Adrenalectomy
Robot-assisted adrenalectomy for complex, large, or right-sided tumours requiring precise dissection near the IVC.
Open Adrenalectomy
Open flank or anterior approach for large (>8 cm) or malignant adrenocortical carcinoma requiring en bloc R0 resection.
COMMON QUESTIONS
Frequently Asked
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