When is adrenal surgery considered?

The main reasons for surgery are when:

  1. There are hormone-producing tumours in the cortex (e.g. adrenal adenomas) or medulla (e.g. phaeochromocytoma)
  2. There is a tumour greater than 3cm in size, even with no evidence of abnormal hormone production, to prevent missing a possible malignancy

A huge adrenal tumour removed at surgery

A huge adrenal tumour removed at surgery - click to enlarge

  1. There is a primary cancer in the adrenal
  2. Patients are experiencing pain symptoms due to an enlarged adrenal gland pressing on adjacent organs

Other rare reasons include bilateral laparoscopic adrenalectomy for Cushing's disease when removal of a pituitary tumour is unsuccessful.