Your gift is 100% tax deductible.
Tests for Adrenal Cancer
Adrenal cancer is sometimes found because it is causing signs or symptoms. In other cases, it may be found by chance during lab tests or imaging tests done for another reason.
If your health care team suspects adrenal cancer, they will do more tests to confirm the diagnosis.
For information on neuroblastoma, a cancer that can begin in the inner part of adrenal glands, see Tests for Neuroblastoma.
Medical history and physical exam
If you have signs or symptoms that suggest adrenal cancer, your doctor will likely start by asking about your medical history and doing a physical exam.
Your medical history
Your doctor might ask:
- Whether anyone in your family has had adrenal cancer or another type of cancer.
- About any symptoms that could suggest a hormone-producing (functional) adrenal tumor. This might include questions about your weight, energy level, hair, sexual function, and any other health problems, such as high blood pressure or heart palpitations.
Your physical exam and other tests
During the physical exam, your doctor will:
- Check your abdomen for any masses or areas of fullness.
- Check your body for signs of extra hormones. This might include a detailed skin and genital exam, depending on your age and symptoms.
If cancer is suspected after the exam, the health care team will do more tests. These might include:
- Imaging tests
- Blood or urine tests
If imaging tests show a mass that is likely to be an adrenal cancer, your doctor will usually recommend surgery to remove it. A biopsy, which removes only part of the tumor for a diagnosis, is generally not recommended for adrenal tumors.
Imaging tests
Imaging tests are used to create pictures of the inside of your body. These tests might be done for a number of reasons. They can help your health care team:
- Find out if a suspicious area might be cancer
- Find out if cancer might have started in another part of your body
- Learn how far cancer has spread
- See if treatment is working
- Look for possible signs of cancer coming back after treatment
If you have adrenal cancer, or if your healthcare team suspects you might, you will likely get one or more imaging tests.
The CT scan combines many x-ray pictures to make detailed, cross-sectional images of the soft tissue of your body.
CT scans can be used to describe the size, shape, and density of masses in the adrenal glands. These characteristics help your care team determine how likely it is that an adrenal tumor is cancer. In most cases, CT scans are the best test to see the adrenal glands and can also be used to help doctors determine if a growth has spread.
An MRI creates detailed images of the soft tissues inside your body. This is done using radio waves and strong magnets instead of x-rays. There is no radiation. A contrast material called gadolinium might be injected into your vein before a scan. This helps doctors to see details better. An MRI scan can usually show better details than a CT scan.
MRIs can be used to:
- Look at an abnormal area and provide more detail.
- Help doctors see how much cancer is in your body (the extent of a tumor).
MRI scans are also helpful in looking at the brain. If you have a higher level of cortisol than normal, sometimes imaging of the pituitary gland in the brain might be needed to look for a cause. In this case, an MRI might be used.
For a PET scan, a slightly radioactive tracer is injected into the blood and collects mainly in cancer cells. Your care team uses a special camera to see areas of radioactivity.
PET scans might be used in some cases where other imaging test results were not clear. PET scans are very good at detecting cancer.
The MIBG scan is used mainly for cancers of the adrenal medulla. These include malignant pheochromocytoma and neuroblastoma.
For this test, a form of the chemical meta-iodobenzylguanidine (MIBG) that contains a small amount of radioactive iodine is injected into a vein. MIBG is similar to norepinephrine, a hormone made by nerve cells.
This helps doctors know where cancers of the adrenal medulla are. They can see if they have spread to the bones and/or other parts of the body.
Biopsy
Imaging and blood or urine test results together are often useful in diagnosing an adrenal cancer. Unlike some other cancers, benign and cancerous adrenal tumors can look similar when biopsy tissue is examined under the microscope. An adrenal cancer is diagnosed using the combined results of these tests.
For adrenal tumors that may be cancer, doctors usually recommend removing the entire tumor rather than taking a small sample (biopsy).
Usually, a doctor will not do a needle biopsy procedure or remove only part of a suspicious tumor in the adrenal gland because it could spread the cancer cells. However, if the suspicious area in the adrenal gland looks like it spread from another part of the body, such as the liver, your doctor may do a needle biopsy there to help diagnose it.
Testing for extra adrenal hormones
Blood and urine tests can be important in diagnosing adrenal cancer. They show whether an adrenal tumor is making hormones (functional). Doctors might choose which tests to do based on symptoms. But they often check hormone levels even when there are no symptoms. Hormone levels can be abnormal even before symptoms appear.
Tests for high cortisol
If an adrenal tumor is making cortisol, these levels will be higher than normal. Cortisol can be measured in the urine, saliva, and blood. To check your cortisol levels, your doctor may do a urine test, saliva test, or a blood test.
Tests for high aldosterone
If an adrenal tumor has been found and you have high blood pressure or low potassium, your doctor may suspect your aldosterone levels might be too high. High aldosterone levels can lower the amount of renin and potassium in the blood. Blood tests can check your renin, aldosterone, and potassium levels to confirm.
Tests for catecholamines
The adrenal gland makes hormones called catecholamines. These include epinephrine (adrenaline) and norepinephrine. When the body breaks these hormones down, they leave the body in urine. The broken-down hormones are called metabolites.
If a tumor, such as a pheochromocytoma or neuroblastoma, is making catecholamines, the amount of certain metabolites in urine or blood will be higher than expected.
Tests for high sex hormones
If you have symptoms that suggest a tumor is making extra sex hormones, your doctor may do a blood test to check those levels.
- Written by
- References
Developed by the American Cancer Society medical and editorial content team with medical review and contribution by the American Society of Clinical Oncology (ASCO).
Adler GK, Stowasser M, Correa RR, et al. Primary Aldosteronism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2025;110(9):2453-2495
Asban A, Patel AJ, Reddy S, Wang T, Balantine CJ, Chen H. Chapter 68: Cancer of the Endocrine System. In: Niederhuber JE, Armitage JO, Dorshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa. Elsevier: 2020.
Bombardieri E, Giammarile F, Aktolun C, et al. 131I/123I-metaiodobenzylguanidine (mIBG) scintigraphy: procedure guidelines for tumour imaging. Eur J Nucl Med Mol Imaging. 2010;37(12):2436-2446.
Fassnacht M, Assie G, Baudin E, et al. Adrenocortical carcinomas and malignant phaeochromocytomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(11):1476-1490.
Lacroix A. Clinical Manifestations and diagnosis of adrenocortical carcinoma. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-adrenocortical-carcinoma on June 23, 2026.
Nieman LK, Biller BM, Findling JW, et al. The diagnosis of Cushing's syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2008;93(5):1526-1540.
Taïeb D, Hicks RJ, Hindié E, et al. European Association of Nuclear Medicine Practice Guideline/Society of Nuclear Medicine and Molecular Imaging Procedure Standard 2019 for radionuclide imaging of phaeochromocytoma and paraganglioma. Eur J Nucl Med Mol Imaging. 2019;46(10):2112-2137.
Yip L, Duh QY, Wachtel H, et al. American Association of Endocrine Surgeons Guidelines for Adrenalectomy: Executive Summary. JAMA Surg. 2022;157(10):870-877.
Young WF. Clinical Manifestations and diagnosis of pheochromocytoma. UpToDate. 2026. Accessed at https://www.uptodate.com/contents/clinical-presentation-and-diagnosis-of-pheochromocytoma on June 23, 2026.
Last Revised: October 5, 2026
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
American Cancer Society Emails
Sign up to stay up-to-date with news, valuable information, and ways to get involved with the American Cancer Society.
