Signs and Symptoms of Adrenal Cancers

Adrenal tumors can cause symptoms in two ways:

• By producing extra hormones
• By pressing on nearby tissues, blood vessels or nerves as they grow

Some adrenal tumors are not cancer, but they still may cause symptoms.

If you or your child have any of the signs or symptoms described here, tell your doctor. These symptoms can have many causes. The only way to know for sure what is causing any symptoms is to see your healthcare provider and have additional tests, if needed.

For information on neuroblastoma, a cancer that often begins in the inner part of adrenal glands, see Signs and Symptoms of Neuroblastoma.

Symptoms caused by hormone production

Some adrenal tumors produce hormones. These are called functional tumors. Symptoms from these tumors vary depending on what hormones they produce.

Sex hormones: Early puberty in children and changes in adults

In young children, extra sex hormones made by a tumor can cause early puberty symptoms such as:

• Hair growth on the face and body, such as in the pubic and underarm areas
• Growth of the testicles or penis in boys or the clitoris in girls
• Development of the breast tissue in girls or enlarging breast tissue in boys

In adults, higher levels of sex hormones are less likely to cause noticeable symptoms, but might include:

• Changes in hair growth or pattern of hair growth
• Changes in sexual desire and function, including erectile dysfunction
• Irregular menstrual cycles
• Deepening voice
• Enlarging breast tissue in males

Cortisol: Cushing syndrome symptoms

Too much cortisol in the body can cause a condition called Cushing syndrome. Some people have all these symptoms, but many people have only a few. Possible signs and symptoms of high levels of cortisol can include:

• Weight gain, often most noticeable in the cheeks (moon face), back of the neck, and abdomen
• Purple stretch marks on the abdomen
• Excessive hair growth on the face, chest, and back in women
• Changes in menstrual cycles
• Weakness and loss of muscle mass in the legs
• Easy bruising
• Depression or mood changes
• Weakened bones (osteoporosis)
• High blood sugar levels
• High blood pressure

Cushing syndrome may be caused by an adrenal cancer or an adrenal adenoma that makes high levels of cortisol and/or related hormones. But this syndrome can also have other causes.

Benign (not cancer) pituitary gland tumors can make high levels of another hormone called adrenocorticotropic hormone (ACTH). This condition is often called Cushing disease. The high levels of ACTH can cause normal adrenal gland tissue to make more cortisol.

Aldosterone: High blood pressure and low potassium

Tumors that produce too much aldosterone can cause:

• High blood pressure
• Low potassium levels in the blood
• Weakness
• Muscle cramps

Adrenal tumors that make aldosterone are more often benign (noncancerous) than cancerous.

Catecholamines: Adrenaline and stress hormones

Catecholamines are stress hormones, such as adrenaline, that the body normally makes in response to stress. When a tumor produces too much of these hormones, it can cause symptoms such as:

• High blood pressure
• Headaches
• Episodes of heavy sweating
• Very fast heartbeat (palpitations)

Tumors that make catecholamine usually come from the adrenal medulla. In adults the most common adrenal medulla tumor is a pheochromocytoma. About 1 in 10 pheochromocytomas is cancer.

Before surgery to remove a pheochromocytoma, a medicine is given to block the catecholamine hormones. This makes surgery safer.

In children, neuroblastomas can also produce catecholamines.

Symptoms caused by the size or location of an adrenal tumor

As an adrenal tumor grows, it can press on nearby organs and tissues, causing symptoms, such as:

• Pain near the tumor
• A feeling of fullness in the abdomen
• Low appetite or feeling full quickly
• Weight loss
• Fever
• Low energy