Diagnosis
If a person has any symptoms of adrenal cancer, a doctor should conduct a physical examination and take their full medical history. During the physical exam, the doctor should thoroughly examine the patient for any lumps or symptoms. If the doctor suspects adrenal cancer, he or she may recommend any of the following methods or procedures to diagnose and stage the disease.
Blood Tests
The doctor may recommend blood tests to measure the levels of different hormones in your blood. Overproduction of certain hormones may indicate an adrenal tumor, but not necessarily cancer. If the blood tests detect elevated hormone levels, the doctor will more likely recommend further testing. The doctor may also perform a blood chemistry test to monitor organ function.
Urine Tests
The doctor may recommend a 24-hour urine test to measure the levels of various hormones in your urine. By collecting all urine for 24 hours, the doctor can measure the average levels of a substance in the urine over the entire day and get a better understanding of what is going on in the body. Overproduction of certain hormones may indicate an adrenal tumor, but not necessarily cancer. If the urine test detects elevated hormone levels, the doctor will more likely recommend further testing.
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Computed Tomography (CT) Scan
For a CT scan, you lie flat on a table while a machine rotates around the body and takes pictures. It produces detailed cross-sectional images of the body, allowing doctors to pinpoint the exact location of the cancer in your body and check for cancer that may have spread to other organs. A CT scan can show the size and location of a tumor on the adrenal glands, and whether it has spread to nearby organs or lymph nodes. Doctors can usually diagnose adrenal cancer based on the size and shape of the tumor on a CT scan. Malignant adrenal tumors are usually much larger than benign tumors and have ill-defined edges.
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Magnetic Resonance Imaging (MRI) Scan
MRI is a test that uses a large magnet, radio waves, and a computer to produce very clear images of the human body. An MRI may be used to further evaluate whether an adrenal tumor is benign or malignant.
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Positron Emission Tomography (PET) Scan
A PET scan shows the activity and locations of the cancer cells in different parts of the body based on detected radioactivity levels. It uses a radioactive glucose that is absorbed in the tumor tissues and sites of inflammation. PET scans are often combined with CT scans and can help identify areas of cancer spread outside the adrenal gland. Doctors usually use PET scans when they think the cancer might have spread but do not know where.
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Biopsy
Adrenal biopsies are most likely not needed for diagnosing adrenal cancer. Adrenal cancer often appears as a large mass that will require resection. A biopsy can be obtained occasionally if there is suspicion for cancer that may have spread outside the adrenal gland to confirm the diagnosis of adrenal cancer. Sometimes the doctor may perform a needle biopsy on a metastatic tumor that has spread to the adrenal gland from another part of the body. In these cases, a biopsy may help the doctor plan the best course of treatment.
