Adrenal Conditions & Procedures

What is the Adrenal Gland?

The adrenal glands are two small, triangular-shaped glands that sit above each kidney. They produce steroid hormones that regulate some key functions of your body, including stress responses, metabolism (energy conversion), blood pressure, and sex hormone regulation.

Some diseases cause excess production of the steroids produced by the adrenal glands, which result in various health problems. These diseases include:

• Pheochromocytoma: This is a rare tumor that develops in the adrenal medulla (the inner part of the gland) that produces excess adrenaline and other hormones. This can lead to very high blood pressure, headaches, sweating, heart palpitations and anxiety. Rarely, tumour outside of the adrenal gland can also secrete excess adrenaline (paraganglionoma). Surgery can cure pheochromocytoma and paraganglionomas and reduce the risk of serious health complications of excess adrenaline.

• Conn's Syndrome (Primary Aldosteronism): This occurs when one or both adrenal glands produce too much aldosterone, a hormone that regulates blood pressure through the balance of water, sodium and potassium levels. This can cause high blood pressure that does not respond to treatment with medication. Some patients may also suffer from low potassium that needs tablets to replace. If the excess aldosterone is coming from just one of the adrenal glands, surgery can often cure the condition.

• Cushing's Syndrome: This condition is due to high levels of the hormone cortisol. High levels of cortisol in the blood can lead to problems like diabetes, high blood pressure, weak bones (osteoporosis), weight gain, stretch marks and mood changes. Surgery can can remove the tumour and allow the body to recover from the effects of excess cortisol.

• Adrenal Incidentaloma: Sometimes, a tumor is discovered on the adrenal gland during imaging tests done for other reasons. These are called adrenal incidentalomas. Many are benign and don't require treatment. However, surgery might be recommended if the tumour is growing or if cancer cannot be ruled out.

• Adrenal Metastases: These are cancerous tumours from other parts of the body that have spread to the adrenal gland. Cancers that can spread to the adrenal gland include melanoma, renal cell carcinoma, lung cancer and breast cancer. Sometimes, if there is a single deposit of cancer in the adrenal gland and no other sites of spread, removal of the cancer deposit with adrenalectomy can be of benefit.

In most of these cases, the goal is to remove the affected adrenal gland on one side. This is often done with key hole surgery, using small incisions and a camera, which means less pain and a quicker recovery. However, sometimes a traditional open surgery is necessary. Dr Hii has subspecialty training in multiple approaches to adrenal surgery and can provide a personalised approach to your adrenal problem with a focus on excellent outcomes, pain minimisation and rapid recovery.