Adrenal tumors can be benign or malignant and may be functional (hormone-secreting) or non-functional. Functional tumors cause clinical syndromes such as Cushing’s syndrome (cortisol excess), Conn’s syndrome (aldosterone excess), pheochromocytoma (catecholamine excess), or virilization. Non-functional tumors are often detected incidentally on imaging.

Symptoms vary depending on hormone excess: hypertension, weight gain, diabetes, palpitations, or virilization. Large tumors may cause flank pain or abdominal fullness.

Diagnosis involves hormonal evaluation (blood and urine tests) and imaging (CT/MRI). Functional imaging such as MIBG scans may be used for pheochromocytoma.

Treatment depends on tumor type. Laparoscopic or robotic adrenalectomy is the standard for most adrenal tumors. Open surgery is reserved for large or invasive cancers such as adrenal cortical carcinoma. Medical management (alpha-blockers for pheochromocytoma) is crucial before surgery.

Prognosis varies. Benign tumors and pheochromocytomas are curable with surgery. Adrenal cortical carcinoma has a poorer prognosis but is managed with surgery, mitotane, and systemic therapies.