Treatment of an Adrenal Mass

An adrenal adenoma, or adrenal mass, is a benign mass, or tumor, situated in the adrenal glands, which are found on top of the kidneys. The adrenal cortex forms the outside layer of the gland, which is where adenomas usually form. Adenomas are either functioning---which means they produce hormones, and thus are more dangerous---or non-functioning. Either way, adenomas can create grave risks for the health of an individual, and must be dealt with immediately. Unfortunately, lifestyle changes, including diet, exercise and herbal remedies, are not effective in treating adenomas: surgery is the only safe and effective option.

Biopsy

• Adrenal biopsies may be performed if it is suspected that you have an adenoma or if you may have an infection. Biopsies are usually performed in conjunction with live CT scans to provide a visual with which a doctor can guide the needle into the skin of an individual's adrenal gland. Local anesthesia prevents you from feeling pain. Alternatively, a laparotomy procedure may be performed. This type of surgery requires an incision to allow access to the abdominal cavity. Often a lab will look at the tissue taken during the biopsy and determine while you are still asleep whether or not you require surgery to remove the adrenal glands. The surety of this procedure makes biopsy/laparotomy an attractive option for certain types of adrenal masses.

Laparoscopic Adrenalectomy

• A laparoscopic procedure is the most commonly recommended procedure, and many doctors consider it the most effective treatment for an adenoma. During this procedure, a series of tiny incisions are made to allow access to the abdominal cavity which is blown up like a balloon to push organs back from the instruments being used. A camera is inserted into one of the incisions, and the others are used to place instruments into the cavity to allow a surgeon to remove the adenoma. To ensure success, the adrenal artery and renal vein are clipped and cut. This prevents blood flow into the area during the procedure and allows for the adrenal glands to be removed safely. Some surgeons place a cloth receptacle, like a bag, into the abdominal cavity, which allows the severed adrenal glands and other tissues to be collected and removed through the incisions.

Abdominal Laparotomy

• Sometimes a surgeon prefers an abdominal laparotomy, which is typically a more invasive procedure with a larger incision. Laparotomies can be shorter procedures than laparoscopies; however, the recovery time for this type of procedure is considerably longer. Certain situations, such as bilateral disease or pheochromocytoma (a neuroendocrine tumor) call for laparotomy surgical procedures. For this type of treatment, one large incision is made which allows access to the abdominal cavity. General anesthesia is administered to put you to sleep and ensure that you feel no pain. An examination and removal procedure can be performed in the same visit for this type of surgery, meaning that biopsy and surgery can take place in the same day. Exploratory laparotomies are sometimes recommended for certain types of disease.