From the Guidelines
Adrenal gland adenomas typically do not cause pain, while adrenal carcinomas can cause pain as they grow larger. Adrenal adenomas are usually non-functional, small (less than 4 cm), and discovered incidentally during imaging for other conditions, as noted in the study on neuroendocrine tumors 1. These benign tumors rarely produce symptoms unless they secrete excess hormones like cortisol, aldosterone, or catecholamines, which cause specific syndromes rather than pain. In contrast, adrenal carcinomas often grow large before detection and may cause abdominal or flank pain due to their size, compression of nearby structures, or invasion into surrounding tissues, as suggested by the characteristics of adrenal carcinoma in the same study 1.
Some key characteristics of adrenal carcinomas that may indicate pain include:
- Size larger than 4 cm
- Irregular margins
- Internal heterogeneity
- Adjacent lymph nodes or liver metastases on CT scans
- High Hounsfield unit (HU) number on unenhanced CT scans Pain may also occur if the tumor hemorrhages or if metastasis develops in bones or other organs. The presence of pain with an adrenal mass should raise suspicion for malignancy or complications like hemorrhage, especially when accompanied by other symptoms like unexplained weight loss, night sweats, or a palpable abdominal mass, as would be considered in the evaluation and treatment of adrenal carcinoma 1.
Given the potential for adrenal carcinomas to cause significant morbidity and mortality, prompt evaluation of painful adrenal masses is essential as it may indicate a more aggressive disease requiring urgent intervention, such as laparoscopic adrenalectomy or medical management with adrenostatic agents like ketoconazole or mitotane, as discussed in the context of Cushing syndrome and adrenal carcinoma 1.
From the Research
Adrenal Gland Adenomas or Carcinomas and Pain
- Adrenal gland adenomas or carcinomas can cause a variety of symptoms, but the provided studies do not directly address whether they can cause pain 2, 3.
- The studies focus on the diagnosis and differentiation of adrenal gland tumors, including adenomas and carcinomas, using imaging and molecular markers 2, 3.
- Adrenocortical carcinomas (ACCs) are rare malignant tumors of the cortex, and adrenal adenomas are the most common benign adrenal tumors that arise from the cortex 2.
- The diagnosis of adrenal disease can be challenging, and misdiagnosis may lead to suboptimal management and adverse outcomes 2.
- While the studies provide information on the clinicopathological features and biomarkers of adrenal gland tumors, they do not specifically discuss pain as a symptom 2, 3.
- Therefore, based on the provided evidence, it is unclear whether adrenal gland adenomas or carcinomas can cause pain, as this topic is not directly addressed in the studies 2, 3.