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Adrenal gland

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Malignant tumours of the adrenal gland

Malignant tumours of the adrenal gland are cancerous growths that have the potential to spread (metastasize) to other parts of the body. Malignant adrenal gland tumours are rare.

Adrenocortical carcinoma

Adrenocortical (or adrenal cortical) carcinoma is the most common malignant tumour of the adrenal gland. It develops in the cortex (outer layer) of the adrenal gland.

  • more likely to be large with most measuring over 6 cm in diameter
  • discovered if it produces hormones that make changes in the body or when it causes symptoms because it has become very large
  • approximately 70% are functioning tumours that overproduce several hormones made by the adrenal gland
    • Cortisol is the most common hormone overproduced by adrenocortical carcinoma.
    • Other hormones that may be overproduced are aldosterone, androgen and estrogen.
  • appear to occur slightly more often in females
  • tend to affect the right adrenal gland more often than the left gland


Pheochromocytomas start in chromaffin cells of the medulla (inner layer) of the adrenal gland.

Most pheochromocytomas start in the adrenal gland, but they can also start in other parts of the body. These are called extra-adrenal pheochromocytomas or paragangliomas.

  • almost all pheochromocytomas are benign, but some have an increased tendency to be malignant
  • presence of metastases is the only reliable indicator of malignancy
  • both adrenal glands are affected in approximately 10% of cases
  • more likely to occur in people with a genetic disorder, such as multiple endocrine neoplasia (MEN) syndrome or mutations in the succinate dehydrogenase (SDH) genes
  • almost all pheochromocytoma are functioning tumours that overproduce the hormones epinephrine and norepinephrine (called catecholamines)
  • pheochromocytomas occur equally in men and women
  • extra-adrenal pheochromocytomas or paragangliomas
    • occur most often in the abdomen
    • are more likely to be malignant than pheochromocytomas in the adrenal gland

Other adrenal gland tumours

Other tumours can occur in the adrenal glands and are extremely rare.

  • myelolipomas
  • cysts and pseudocysts
  • adenomatoid tumours
  • lymphoma
  • tumours of the adrenal stoma, adipose, neural and vascular tissues


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