Adrenal gland cyst is growth that starts on the adrenal glands. These glands are found on top of the kidneys. The cysts can be small and not show any symptoms. Or, they can grow large and cause problems with hormones or other issues.1 It’s important to know about the symptoms, causes, and what treatments are available. This helps in managing adrenal gland cysts well. This article will cover everything from how they are diagnosed to how they’re treated.
Key Takeaways:
- Adrenal gland cysts are benign growths that can develop on the adrenal glands, small hormone-producing glands located on top of the kidneys.
- Adrenal gland cysts can vary in size and may not always cause symptoms. However, if they grow large, they can lead to hormonal imbalances or other problems.
- It’s crucial to understand the symptoms, causes, and treatment options for adrenal gland cysts to properly manage them.
- Doctors use imaging tests and checks on hormone levels to diagnose adrenal gland cysts. This helps determine how severe they are.
- For treating adrenal gland cysts, options may include close monitoring, taking medications, or in some cases, having surgery to remove them.
What is an Adrenal Gland Cyst?
The adrenal glands are tiny, have a triangle shape, and sit on top of our kidneys. They’re vital for our body’s hormones. This includes making cortisol, aldosterone, and adrenaline. Adrenal gland cysts are noncancerous growths. They form because of too much fluid or when cells grow in an unusual way.2
Understanding the Adrenal Glands
These glands are key for controlling metabolism, the immune system, blood pressure, among others.3 The cortex and medulla are the two types of adrenal tissues. Tumors can grow in either type of tissue.3
Benign vs. Malignant Adrenal Tumors
Benign adrenal gland cysts are mostly harmless, not being cancerous.3 Yet, adrenal gland cancers do occur but are quite rare. Called adrenal carcinomas, these tumors are often big and can make too many hormones. This excess hormone production causes various health symptoms.1 It’s crucial to tell if a tumor is benign or malignant through careful tests.
Symptoms of Adrenal Gland Cyst
Non-functional Cysts
Adrenal gland cysts often don’t cause issues by overproducing hormones.1 They might show up unexpectedly during medical tests done for other issues. People with these cysts usually don’t feel sick because of them.
Functional Cysts and Hormonal Imbalances
Sometimes, these cysts can overwork and make too much of a hormone.3 This leads to different symptoms. For instance, if a cyst makes too much cortisol, you might see a rise in blood sugar levels, high blood pressure, and get heavier. A cyst making too much aldosterone can also push your blood pressure up, while too much of the “fight or flight” hormones like adrenaline could make your heart race, put you in sweat, and bring on headaches.3
adrenal gland cyst
Genetic Syndromes and Mutations
Some genetic conditions can make you more likely to get adrenal gland cysts or tumors. These include MEN 2A and 2B, VHL, and NF1. If you have these, you might more easily get adrenal gland issues, such as cysts.1
Other Risk Factors
Family history and past adrenal surgeries can also up your chance of getting a cyst. But, many times, the real cause of an adrenal cyst is unknown.4
| Adrenal Cyst Type | Percentage of Cases |
|---|---|
| Endothelial Cysts | Nearly 50%4 |
| Pseudocysts | Approximately 40%4 |
| Epithelial Cysts | Around 9%4 |
| Adrenal Cysts in Women | Three times more common than in men4 |
| Mural Calcification in Adrenal Cysts | About 15% of cases4 |
Diagnosis and Testing
Diagnosing an adrenal gland cyst often starts with imaging tests. These include an abdominal ultrasound, CT scan, or MRI. The test’s goal is to find the cyst, check its size and kind, and see if it’s dangerous.5
Imaging Tests
A CT scan produces detailed, 3-D images of the glands.5 MRI scans, on the other hand, use a magnetic field for similar images.5 PET scans can indicate if a tumor is cancerous by finding active tissue.5
Hormone Level Evaluation
Doctors might also check the patient’s hormone levels. This checks if the cyst affects hormone production. They test for cortisol, aldosterone, and other hormones in blood or urine.6 Finding hormone level imbalances helps with the treatment plan.
Blood or urine tests can reveal imbalances in potassium or hormones. They might show signs of conditions like Cushing’s syndrome. Adrenal tumors need various tests to look for specific disorders.6
Sometimes, more tests are needed if the first ones are unclear. This could be due to certain medications affecting the results. For example, the European Society of Endocrinology suggests specific tests to check for hormonal problems or adrenal cancer.6
Important tests for adrenal tumors include measuring different hormones. Doctors might test for catecholamines, cortisol, and others. Sometimes, further tests are necessary for a final, accurate diagnosis.6
Treatment Options for Adrenal Gland Cysts
Monitoring and Watchful Waiting
For small, inactive adrenal gland cysts with no symptoms, doctors might advise watching them carefully.7 This means checking the cyst with regular tests to make sure it’s not changing or causing harm. If the cyst stays the same and doesn’t show any symptoms, there might not be a need to treat it.
Surgical Removal
If the adrenal gland cyst is big, grows, or secretes too many hormones, or appears risky on tests, the doctor might suggest removal surgery.7,8 A skilled endocrine or adrenal surgeon commonly does this surgery. It removes the entire affected adrenal gland. Surgery is often the best option for active cysts or those likely to cause problems.
Managing Symptoms and Complications
People with adrenal gland cysts that make too many hormones might have high blood pressure, diabetes, and gain weight. They might also feel down.3 To help, doctors use medicine, ask for lifestyle changes, and keep a close eye on things.3 Sometimes, fixing the hormonal problem with meds or operation can make symptoms better.3
If a patient’s adrenal gland cyst is overactive, doctors often give special drugs to balance out the hormones.3 This can ease problems like high blood pressure, diabetes, or extra weight.3 Eating better, working out, and stress control can promote health and symptom improvement too.3
When a cyst is big, growing, or hugely messing with hormones, taking out the gland might be needed.1 This surgery aims to set hormone levels right and make the person feel better.1 The health team and the patient decide what’s best for the situation, considering the cyst and the person’s health.1
Checking the cyst with images and hormone tests is key.1 It helps keep track of the cyst’s behavior and guides treatment choices.1 This way, doctors can tell what needs to be done to manage the cyst well.1
Preparing for Surgery
People getting ready for adrenal gland cyst removal surgery will do lots of tests. They’ll have imaging studies, hormone level checks, and a deep look at their health. This is to make sure they’re fit for surgery9. The team of doctors and nurses will also check on their overall health and other medical issues.
Pre-operative Tests and Evaluations
Testing and checking patients before adrenal gland surgery is key. They might have CT scans or MRIs. These show the size, place, and type of cyst in the adrenal gland9. Doctors also check hormone levels. This tells them if the cyst is causing any problems by making too many hormones. It helps choose the right surgery and how to care for the patient after10.
Choosing the Right Surgeon
Picking the right doctor is crucial. Endocrine or adrenal surgeons who are board-certified are best for adrenalectomy. They have the needed know-how and skill. This lowers the chance of problems and leads to a better outcome10. It’s wise for patients to look into the surgeons’ background and experience thoroughly before deciding.
Getting these tests done and choosing a top surgeon boosts patients’ confidence for surgery. It also improves their chances of doing well after adrenal gland cyst removal surgery.
Recovery and Follow-up Care
After the surgery to remove an adrenal gland cyst, people often stay in the hospital for a while11. The amount of time they spend there varies. It depends on how complicated the surgery was and how healthy they are. While in the hospital, doctors and nurses will keep a close eye on things.
They will watch the patient’s vital signs and make sure they heal well. They will also help with any pain or discomfort after the operation.
Post-operative Care
11 Patients usually start eating, drinking, and walking again soon after the surgery. Those who had an open adrenalectomy might wait until the next day. After a laparoscopic adrenalectomy, they may feel some pain but it’s usually not too strong. This type of surgery means they might not need strong painkillers. However, people who had an open adrenalectomy might need these more powerful painkillers.11 The cuts from the surgery will be closed with staples, steri-strips, or bandages. They usually heal in 3-6 months.11 They can take a shower the day after the surgery and may slowly start their daily routines again in 2-4 weeks. It might take longer if the surgery was more complex.
11 Some patients, especially those with cortisol-producing tumors, may need to take steroid pills for a while. They will slowly need less of these as their body returns to normal.11 Any unusual symptoms after surgery, like fever or severe pain, need immediate attention. Other signs to watch for are problems when swallowing, very bad swelling, or issues breathing. A follow-up checkup is usually set for 1-2 weeks after surgery.
11 The American Association of Endocrine Surgeons has helpful information for patients seeking more details.
Lifestyle Modifications
After getting an adrenal cyst removed, patients might have to change some daily habits. This helps with recovery and staying healthy. They might need to adjust their diet, exercise more, and find better ways to manage stress. If their adrenal gland was making important hormones, they might need to take hormone replacements.
Adrenal Gland Cyst in Children
Adrenal gland cysts can happen in children, but they’re rarer than in grown-ups.12 Doctors treat young patients with adrenal gland cysts differently. They consider how the cyst might affect the child’s growth and the risk of hormone problems. These issues relate to the cyst impacting the development of their endocrine system.13
Unique Considerations
A cyst on a child’s adrenal gland can greatly impact their growth and development. This is because these glands are key in controlling hormones, especially when the body is still growing.12 Doctors watch closely for hormonal issues since they can cause serious problems. These include things like unclear sex organs, loss of salt, or troubles in the brain.
Monitoring and Treatment
Doctors keep a close eye on adrenal gland cysts in kids. They watch how the cyst grows and its effects on the child’s hormones.13 The treatment might include routine scans, checks on hormone levels, and sometimes surgery. This is if the cyst becomes troublesome or triggers symptoms.12 If the cyst isn’t causing any problems and it’s not active, doctors might just watch it over time.
Preventing Adrenal Gland Cyst
Unfortunately, there’s no surefire way to stop adrenal gland cysts from forming. The reasons behind their development aren’t totally clear.14 But, if you have a family history of adrenal gland issues, or certain genetic conditions like MEN 2A and 2B, VHL, or NF1, it’s a good idea to get checked often by your doctor.
While we can’t prevent these cysts with certainty, keeping an eye out and having regular health check-ups is important. This can catch any cysts early, which is crucial for good treatment and avoiding problems down the line.15 People at risk should make a healthcare plan for regular check-ups with their specialist.
| Prognostic Features of Adrenocortical Carcinoma | Pathologic features of interest for prognosis were outlined in a study.15 |
|---|---|
| Surgical Cases of Adrenal Cystic Lesions | Report of 12 surgically treated adrenal cyst cases and review of the literature.15 |
| Surgical Management of Adrenal Cysts | Overview of the surgical management and outcomes of adrenal cysts.15 |
| Laparoscopic Management of Giant Adrenal Cyst | A case study highlighting laparoscopic treatment of a large adrenal cyst.15 |
| Adrenal Cyst Clinicopathological Study | An in-depth analysis of vascular adrenal cysts including clinicopathologic and immunohistochemical data.15 |
| Adrenal Cyst Radiological Features | Clinical and radiological characteristics of adrenal cysts examined.15 |
| Experience of Surgical Management | Institutional experience and outcomes of surgical treatment for adrenal cysts.15 |
| Laparoscopic Adrenalectomy | Comparison between the transperitoneal and retroperitoneal approach in treating adrenal tumors in adults.15 |
| Pathological Features of Surgically Treated Adrenal Cysts | A retrospective analysis of the pathological features of surgically managed adrenal cysts.15 |
Outlook and Prognosis
For patients with small, non-functional benign adrenal cysts, the outlook is good. Such cysts often don’t need surgery.16 Doctors will monitor the cysts and treat any symptoms that come up. Removing the cysts can lead to a full recovery and normal adrenal function.
The 5-year relative survival rate for localized adrenal cancer is 73%. When it spreads regionally, this falls to 53%, and even lower at 38% for distant spread.16 Overall, the 5-year survival rate is 50% for all stages combined.16 Yet, these are general numbers. A person’s age, health, how well they respond to treatment, and medical advances can all change these numbers.16
Survival rates can vary a lot between different types and stages of adrenal cancer. For adrenocortical carcinoma (ACC), very early stages are curable about 30% of the time, and the overall 5-year survival rate is 75–90%.17 Pheochromocytomas and paragangliomas tend to have better survival rates, up to 95% for early cases, and 34–60% for advanced ones.17 With new treatments and better ways to find these problems early, the future looks brighter for people with adrenal cysts and tumors.
Source Links
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163428/
- https://casereports.bmj.com/content/16/5/e254535
- https://www.mayoclinic.org/diseases-conditions/benign-adrenal-tumors/symptoms-causes/syc-20356190
- https://www.sciencedirect.com/topics/medicine-and-dentistry/adrenal-cyst
- https://nyulangone.org/conditions/adrenal-tumors/diagnosis
- https://www.adrenal.com/adrenal-tumors/lab-testing
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6174168/
- https://www.mdpi.com/2077-0383/13/3/846
- https://www.sages.org/publications/patient-information/adrenal-gland-removal-adrenalectomy-patient-information-from-sages/
- https://www.mayoclinic.org/tests-procedures/adrenalectomy/about/pac-20385243
- https://www.umms.org/ummc/health-services/surgery/endocrine-surgery/conditions/adrenal-gland/after
- https://emedicine.medscape.com/article/940347-overview
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5305088/
- https://www.sciencedirect.com/topics/nursing-and-health-professions/adrenal-cyst
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8426056/
- https://www.cancer.org/cancer/types/adrenal-cancer/detection-diagnosis-staging/survival-by-stage.html
- https://www.medicalnewstoday.com/articles/how-serious-is-a-tumor-on-the-adrenal-gland
