Adrenal – a pair specialized gland, releasing hormones that affect the maintenance of blood pressure, the exchange of electrolytes (potassium, sodium, magnesium and others). Cancer of these glands is relatively rare, more common benign changes, but because the hormones produced by suprarenalopathy exceed the amount of hormones available to healthy gland, they usually cause different changes. Tumors of the external (cortical) layer of the gland are more often benign.
From the inner layer of the adrenal (brain) can develop two types of tumors – neuroblastoma, affecting mostly children, and pheochromocytoma. Cancerous tumors account for only about 10% of these entities.
Another type of tumors, affect both cortical and adrenal medulla – insidentalomy – so-called silent tumors that do not produce hormones, up to 10% of adrenal tumors.
Clinical picture
Manifestations of the disease depend on the hormone, which provides tumor. Any damage to the cortex of adrenal gland may be Cushing’s syndrome, characterized by significant changes in the body: fat deposits on the body, especially on the back of the neck, hips, muscle weakness, thinning of skin with formation of characteristic bands in the lower abdomen, hips – stretch marks. For women, possible hair growth on face and body of male pattern in tumors that produce male steroid. It is also possible the development of diabetes. Often, the main symptom of the cortical layer of the adrenal tumor is arterial hypertension with constant high blood pressure numbers. In a further possible breach of the kidneys. The above symptoms occur, and adrenal gland cancer, and in benign lesions. Tumors of the adrenal medulla, most pheochromocytomas, produce hormones that affect blood pressure and stress responses, so they can cause a variety of symptoms, but the main manifestation of these tumors is a frequent arterial hypertension with hypertensive crisis. During crises pressure rises to 250-300 at 120-150 mm Hg. After the crisis is accompanied by a decrease in pressure sweating, loss of consciousness, involuntary urination. Hypertensive crises may lead to various complications, the most dangerous of which is a stroke (cerebral infarction or cerebral haemorrhage). These tumors are more common in middle-aged persons. At large sizes adrenal tumors, it can probe through the abdominal wall. Heavy changes to the body accompanying the hormone-producing adrenal tumors, as well as possible complications, suggest an appropriate assessment as soon as possible.
Survey
The clinical picture in itself allows the doctor to assume, in what layer of the adrenal gland – the cerebral cortex or – most likely there are violations.
Instrumentlnye methods
Ultrasound (ultrasonography) is not always possible to identify the adrenal tumor because of inconvenient location of the body. However, in a high class specialists and equipment, suspected adrenal tumors according to ultrasound can. With large tumor diagnosis according to ultrasound easier. CT (computed tomography) and MRI (magnetic resonance imaging): in the case of adrenal tumors, two of these methods are the main instrumental diagnostic methods. In the case of a malignant process is performed to exclude metastasis from lung radiography, radionuclide bone scans of the skeleton.
Laboratory
For diagnosis of adrenal tumors gormonprodutsiruyuschih important to determine the content of certain hormones in the blood and urine, as well as the determination of ACTH (adrenkortikotropnogo hormone) in the blood – the hormone of the pituitary (gland located in the brain governing the work of the adrenal glands). It should be remembered that the identification of any, even malignant disease at an early stage improves the forecast of the forthcoming treatment.
Treatment
Treatment of adrenal tumor surgery. The specialists of our department operations for tumors of the adrenal glands are performed as open access, and laparoscopic (without a large incision, and a few punctures on the anterior abdominal wall). The operation is to remove the affected adrenal gland, and in the case of malignant lesions – removal of adrenal glands from nearby lymph nodes. For the treatment of pheochromocytoma is also used treatment with a radioactive isotope. When injected into a vein isotope penetrates the tumor and causes the death of a sufficient number of cells to reduce tumor size, and even to reduce the size of metastases. In some tumors, chemotherapy gives good results.
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