Diagnosis of Adrenal Gland Tumor

Executive Summary

The diagnosis of an adrenal gland tumor is made by conducting blood and urine tests to look for specific substances to determine if the cancer is functional or non-functional. Several tests can help to diagnose adrenal tumors. Computed tomography (CT or CAT) or magnetic resonance imaging (MRI) can help diagnose and determine if an adrenal tumor is cancerous. In fact, imaging tests can show pictures of the body and can see if a cancerous tumor has spread. MIBG is an adrenaline-like chemical that accumulates in neuroendocrine tumors. Another test, Adrenal Vein Sampling (AVS) is used for examining if extra hormones from the adrenal glands have attached to the tumor. 

Diagnostic Approach

Doctors use many procedures for the diagnosis of adrenal gland tumor. They also do tests to see if the tumor is cancerous and has spread from its origin to another part of the body. If this happens, talk about metastasis. Some tests can also determine which treatment is most effective. Hence, to diagnose an adrenal tumor, doctors do blood and urine tests (see below) to look for specific substances to determine if the cancer is “functional” or “non-functional” ^​1​. Computed tomography (CT or CAT) or magnetic resonance imaging (MRI) can help diagnose and determine if an adrenal tumor is cancerous ^​2​. Imaging tests show pictures of the body and can see if a cancerous tumor has spread. Doctors can also run tests to find out which treatment is most effective.

How to Diagnose Adrenal Gland Tumor

Several tests can help to diagnose adrenal tumors ^​3​. Everyone uses not all tests described here. Your health practitioner may consider the following factors when choosing a diagnostic test: 

• Suspicious tumor type
• Signs and symptoms
• Age and general health
• Results of prior medical tests

Also Read: Screening of Adrenal Cancer

Adding to physical examination to Diagnose Adrenal Gland Tumor, the following tests are available

Blood and urine tests

Blood and urine tests help measure the number of adrenal hormones that tell your doctor if the tumor is functioning, which is an option for Diagnosis of Adrenal Gland Tumor. You may require a 24-hour urine sample. You should collect all urine over 24 hours for clinical trials. Doctors use the test results to track how fast your body produces various hormones.

One of the specific hormones doctors look for in these tests is the stress hormone cortisol. A particular test known as the dexamethasone suppression test checks cortisol levels. This test may ask you to take the pill the night before. This pill contains a drug that reacts like cortisol in the body. When people who do not have adrenal tumors take this drug, their bodies reduce cortisol and other hormones. However, if someone has an adrenal tumor, cortisol levels remain high even after taking medicine. Therefore, tell your doctor about your medications, including over-the-counter medicines, vitamins, and herbal supplements. Also, this information is necessary for the correct interpretation of the test results.

Biopsy

A biopsy is known as removing a small amount of tissue for microscopic examination. If your doctor suspects that the cancer is spreading to the adrenal glands from another part of the body, a biopsy could be done to find out where the cancer started. So, it helps doctors plan treatment.

During the biopsy, the tissue is removed with a fine hollow needle. It is called a fine needle biopsy or fine-needle suction. A radiologist performs the biopsy inserts the needle directly into the tumor using a unique imaging technique such as a CT scan. Next, the pathologist analyzes the sample taken during the biopsy. The pathologist interprets the laboratory tests and assessing cells, tissues, and organs to diagnose disease. In order to ensure that the tumor does not produce catecholamines, one has to test hormone production before a biopsy of an unknown Adrenal Gland mass.

CT or CAT scan for Adrenal Gland Tumor

A CT scan is taken under the Diagnosis of Adrenal Gland Tumor, where images of the body are recorded using x-rays from different angles. The computer then combines these images to create a detailed 3D image showing the abnormality or tumor. A special dye improves the print details called a contrast agent given before scanning. The dye is injected into the patient’s vein via the peripheral vein (IV) line. It is a short plastic tube inserted into a vein, allowing the medical team to administer medicines and liquids.

MRI

MRI scanners use magnetic fields instead of x-rays to generate detailed body images. M can also measure the size of an adrenal gland tumor. Before scanning, a special dye called a contrast agent is given to create a clearer image. This dye can be injected into the patient’s vein or swallowed as a pill.

Metaiodobenzylguanidine (MIBG) scan

MIBG is an adrenaline-like chemical that accumulates in neuroendocrine tumors. MIBG scans may show Adrenal Gland medulla tumors that may not be visible on x-rays. The scan is done for two consecutive days. You have to take the MIBG injection in the arm on the first day. After a few hours, take a picture with a special camera to show if and where the MIBG has accumulated in the body. More photos are taken the following day, and this process can be repeated as needed.

Adrenal Vein Sampling (AVS)

In rare cases, the patient may have symptoms of a hormone-producing tumor but CT or MRI scans may not identify cancer. Doctors diagnosed if the patient has any occurrence of small masses in both adrenals. In such cases, the interventional radiologist can test the blood from the veins of each adrenal gland. Examination of the blood in each gland helps to find if extra hormones from the adrenal glands have attached to the tumor. Only specialists can perform this process in a unique radiation Centre.

DOTA-TATE Positron Emission Tomography (PET) or PETCT scan

Usually, specialists combine PET scans with CT scans called PET or PETCT scans. During this test, the specialist injects a small amount of a radiopharmaceutical drug called a tracer into the patient’s vein. It then scans the body to show where the radiation has accumulated. However, the amount of radiation in the substance is very low to cause any harm. Pheochromocytoma is suspected of being inherited, recurrent, or occurring in multiple locations. One can identify it by a special PET scan using a special compound called DOTATATE. It is a recent scan that helps assess these conditions.

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