Arthur Smith Institute for Urology, New Hyde Park, NY :: 516.734.8500

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Adrenal Cancer

Diagnosis

If an adrenal tumor is found or suspected, along with a thorough history and physical exam, your doctor may order several tests to make the diagnosis. Blood and urine samples may reveal elevated levels of specific hormones produced by the adrenal gland. More invasive blood testing, such as adrenal venous sampling or dexamethasone suppression test, may be needed to clarify the cause and source of the elevated adrenal hormones.

An important part of the work up for adrenal tumors is diagnostic imaging. The most common imaging tests are CT scans and MRI scans. These scans give the doctor an anatomic picture of the adrenal glands and the adrenal tumors. Based on the imaging characteristics (e.g. size and brightness), your doctor may be able to differentiate between benign and malignant tumors. Occasionally, your doctor may order more specialized imaging tests, such as MIBG scan or PET scan to clarify the diagnosis. These studies involve injecting a small amount of a radioactive contrast dye in your veins and monitoring whether the adrenal tumor becomes bright on the images.

If the tests described above do not make the diagnosis clear, your doctor may schedule a biopsy of the adrenal lesion. This procedure is generally done in collaboration with an interventional radiologist. The procedure involves placing a small needle through your skin into the tumor under the guidance of ultrasound or CT scan. Through the small needle, a sample of the tumor can be removed. The pathologist can then look at the sample under the microscope to make the diagnosis.