What Is an Adrenal Adenoma and Typical Symptoms
An adrenal adenoma is a benign (non-cancerous) tumour arising in the cortex of one of the two adrenal glands, which sit just above your kidneys. Most adrenal adenomas are non-functioning, meaning they do not produce excess hormones. These are frequently discovered by chance during an abdominal scan carried out for an unrelated reason, such as digestive pain or a routine health check. Clinicians often refer to these as adrenal incidentalomas.
When an adrenal adenoma is functioning, it overproduces specific adrenal steroid hormones. The resulting symptoms depend directly on which hormone is involved:
- Excess Cortisol: Overproduction causes hypercortisolism, which can develop into Cushing's syndrome. Signs include unexplained weight gain around the trunk and neck, facial rounding, easy bruising, muscle weakness in the upper legs, fragile skin, mood changes, and elevated blood glucose levels.
- Excess Aldosterone: Known as primary aldosteronism or Conn's syndrome, this leads to persistent high blood pressure that often requires multiple antihypertensive medications to control, frequently accompanied by low blood potassium levels (hypokalaemia), muscle cramps, and fatigue.
- Excess Sex Hormones: In rarer instances, adenomas produce excess androgens or oestrogens, causing unwanted hair growth, menstrual irregularities, or male breast tissue enlargement (gynaecomastia).
If you suspect an endocrine imbalance, an evaluation through specialised Endocrinology services helps determine whether an adrenal nodule is metabolically active.
How Adrenal Adenoma Is Diagnosed
Hospitals in Turkey approach adrenal tumours using a structured diagnostic pathway designed to answer two fundamental clinical questions: is the tumour benign, and is it producing hormones? Rather than relying solely on past reports, medical teams confirm findings through dedicated cross-sectional imaging and biochemical screening.
Diagnostic assessments typically include:
- Dedicated Adrenal Imaging: An unenhanced adrenal CT scan measures tumour density in Hounsfield units (HU). Benign adenomas are typically lipid-rich with attenuation values below 10 HU. When lipid-poor, a contrast-enhanced washout CT or chemical-shift MRI is performed to evaluate how rapidly contrast washes out, differentiating an adenoma from other adrenal lesions.
- Hormonal Workup: Blood and urine tests evaluate functional status. Standard tests include an overnight 1 mg dexamethasone suppression test to assess cortisol regulation, a plasma aldosterone-to-renin ratio (ARR) to screen for Conn's syndrome, and plasma or 24-hour urinary fractionated metanephrines to rule out a phaeochromocytoma (a tumour of the adrenal medulla) before any intervention.
- Comprehensive Baseline Testing: Routine blood counts, renal function, liver panels, and electrolyte evaluations performed under Check-ups & Diagnostics help the clinical team understand your general health.
When travelling for consultation, you should bring original DICOM imaging files on a disc or USB drive, copies of past radiologist reports, historical blood pressure logs, and a complete summary of your current medications, especially blood pressure and hormone drugs.
Treatment Options and When Each Is Used
Management depends on tumour size, imaging characteristics, and whether the adenoma produces hormones. Small, non-functioning adenomas with reassuring imaging features usually do not require surgery, whereas functional or suspicious growths warrant active intervention.
| Option |
Typically used when |
Things to know |
| Active Surveillance |
Non-functioning tumours under 4 cm with clear benign imaging features (lipid-rich). |
Involves repeat imaging and periodic hormone checks over several years to verify stability; avoids unnecessary surgery. |
| Laparoscopic Adrenalectomy |
Hormone-producing adenomas or non-functioning tumours growing larger than 4 cm. |
Minimally invasive keyhole surgery performed under General Surgery or Urology; offers faster healing and reduced post-operative discomfort. |
| Robotic Adrenalectomy |
Complex anatomical locations, larger benign lesions, or patients with previous abdominal surgery. |
Provides high-magnification 3D visualisation and articulated instruments; allows precise tissue dissection around delicate retroperitoneal blood vessels. |
| Medical Management |
Aldosterone-producing adenomas where surgery is contraindicated, or while preparing for an operation. |
Uses targeted medications like mineralocorticoid receptor antagonists (spironolactone or eplerenone) to control blood pressure and normalize potassium levels. |
If imaging shows indeterminate features, high density (greater than 20 HU without washout), or irregular margins, multidisciplinary review with Oncology specialists may be requested to exclude malignancy.
Planning Treatment in Turkey
Travelling for adrenal care requires structured preparation. Before departure, your medical records, scan images, and laboratory results are reviewed remotely by an endocrinologist and an endocrine surgeon. This preliminary assessment establishes whether surgery is likely required or if confirmatory testing is the appropriate initial step.
For surgical treatment, patients typically need to remain in Turkey for 7 to 10 days. This timeline allows 1 to 2 days for pre-operative consultations, blood cross-matching, and anaesthetic clearance; 2 to 3 days of hospital stay following minimally invasive surgery; and several days of local outpatient recovery before a fit-to-fly assessment. If your tumour was producing cortisol, your remaining adrenal gland may be temporarily suppressed, requiring temporary oral hydrocortisone therapy and a precise tapering schedule managed by your endocrinologist.
Before returning home, you will receive your discharge summary, operative report, and pathology results translated into English. Ongoing monitoring requires close cooperation with your local doctor or endocrinologist, including periodic blood pressure checks, electrolyte monitoring, and annual follow-up scans if non-surgical surveillance was chosen.
When Travel Is Not Advisable and Warning Signs
Adrenal disorders can involve significant physiological instability. You should postpone international travel and seek immediate local emergency care if you experience any of the following warning signs:
- Severe, sudden spikes in blood pressure accompanied by pounding headaches, heart palpitations, or chest discomfort.
- Signs of adrenal crisis, such as persistent vomiting, severe dehydration, profound dizziness, confusion, or sudden low blood pressure.
- Unexplained severe electrolyte disturbances, such as critically low potassium causing muscle paralysis or cardiac arrhythmias.
- Severe abdominal or flank pain with sudden anaemia, which could indicate spontaneous tumour haemorrhage.
All therapeutic decisions are made by your treating doctor following in-person examination and full clinical review. Stable travel clearance is essential to ensure a safe journey and smooth recovery.
