Tumor of the adrenal glands

The adrenal glands are paired specialized glands that release hormones that affect the maintenance of blood pressure, the exchange of electrolytes (potassium, sodium, magnesium, and others). Cancer of these glands is relatively rare, benign changes are more common, but since the hormones produced by the affected adrenal glands exceed the number of hormones secreted by a healthy gland, they traditionally cause all kinds of changes. Tumors of the outer (cortical) layer of the gland are more often benign.

Two main types of tumors can develop from the inner layer of the adrenal gland (the medulla): neuroblastoma, which mainly affects babies, and pheochromocytoma. Cancer tumors make up only within 10% of these formations.

Another type of tumor that affects both the cortex and the medulla of the adrenal gland – incidentalomas – the so-called silent tumors that do not secrete hormones, account for up to 10% of all tumors of the adrenal gland.

Clinical picture

The manifestations of the disease depend on the hormone that the tumor secretes. With damage to the adrenal cortex, the development of Cushing’s syndrome is likely, which is characterized by significant changes in the body: fat deposits on the body, especially on the back of the neck, thighs, muscle weakness, thinning of the skin with the formation of characteristic stripes on the lower abdomen, thighs – striae. In women, male-pattern hair growth on the face and body is possible with tumors that secrete male steroids. It is also possible to develop diabetes. Not often, the main symptom of an adrenal cortical tumor is arterial hypertension with persistently elevated blood pressure numbers. In the future, violations of the kidneys are possible. The above symptoms occur in both adrenal cancer and benign lesions. Tumors of the adrenal medulla, more commonly pheochromocytomas, produce hormones that affect blood pressure and stress responses, so they can cause a wide variety of symptoms, but the main manifestation of such tumors is arterial hypertension with frequent hypertensive crises. During crises, the pressure rises to 250–300 per 120–150 mm Hg. After the crisis, the decrease in pressure is accompanied by sweating, loss of consciousness, involuntary urination. Hypertensive crises can lead to various complications, the most dangerous of which is a stroke (cerebral infarction or cerebral hemorrhage). These tumors are more common among middle-aged people. With large volumes of adrenal tumor, it can be felt through the abdominal wall. Severe changes in the body

Survey

The clinical picture itself allows the doctor to suggest in which layer of the adrenal gland – cortical or medulla – most likely there are violations.

Instrumental Methods

Ultrasound (ultrasound examination) does not always reveal a tumor lesion of the adrenal gland due to the inconvenient location of this organ. However, with a high-class specialist and equipment, it is possible to suspect an adrenal gland tumor according to ultrasound data. With large volumes of the tumor, it is easier to make a diagnosis according to ultrasound. CT (computed tomography) and MRI (magnetic resonance imaging): in the case of an adrenal tumor, these two methods are the main instrumental diagnostic methods. In the case of a malignant process, to exclude metastasis, an x-ray of the lungs and a radioisotope scan of the bones of the skeleton are performed.

Laboratory methods

For the diagnosis of hormone-producing tumors of the adrenal glands, it is important to determine the content of certain hormones in the blood and urine, as well as to determine the content of ACTH (adrenocorticotropic hormone) in the blood – the hormone of the pituitary gland (a gland located in the brain that regulates the work of the adrenal glands). It should be remembered that the detection of any, even a malignant disease at an early stage improves the prognosis of the upcoming treatment.

Treatment

Surgical treatment of tumors of the adrenal gland. The specialists of our department perform operations for tumors of the adrenal glands both by open access and laparoscopically (without a large incision, but through several openings on the anterior abdominal wall). The operation consists in the removal of the affected adrenal gland, and in the case of a malignant lesion, the removal of the adrenal gland with nearby lymph nodes. Radioactive isotope treatment is also used to treat pheochromocytoma. When injected into a vein, the isotope penetrates the tumor and causes enough cell death to shrink the tumor and even reduce the size of metastases. For some tumors, chemotherapy gives good results.

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The duration of the sick leave after removal of the tumor of the adrenal gland and 12th rib

Answer #1

The operation may be complicated, or it may be uncomplicated, therefore, the duration of treatment is different for everyone. The attending physician decides on its duration, and if the length of stay is delayed compared to the standard ones according to the MES, then the decision to extend the b / l is made jointly with the head of the department hospital or the clinic where the patient is sent for aftercare.

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