Your Adrenal Glands

The adrenal glands are orange-colored endocrine glands which are located on the top of both kidneys. The adrenal glands are triangular shaped and measure about one-half inch in height and 3 inches in length. Each gland consists of a medulla (the center of the gland) which is surrounded by the cortex. The medulla is responsible for producing epinephrine and norepinephrine (adrenaline). The adrenal cortex produces other hormones necessary for fluid and electrolyte (salt) balance in the body such as cortisone and aldosterone. The adrenal cortex also makes sex hormones but this only becomes important if overproduction is present.

Indications for Surgical Removal of Adrenal Glands

The indications for surgical removal of the adrenal gland are relatively straightforward and include, but are not limited to the following:

• Tumors of the adrenal cortex which overproduce hormones. One such tumor is shown in the picture...it is the round yellow mass located within the triangular adrenal gland. This picture is blown up about 2-fold to make it easier to see. The normal adrenal gland is NOT this big. Endocrine glands are very important despite their small size since they make important hormones.
• Tumors of the adrenal medulla which overproduce adrenaline (pheochromocytoma).
• Most solid tumors of the adrenal gland which are greater than 4 cm (~2 inches) regardless of whether they produce hormone or not (to rule out malignancy).
• Primary cancers of the adrenal.
• Any size adrenal mass which causes symptoms such as flank pain or tenderness.

Note: the above conditions which indicate the surgical removal of an adrenal gland all exclude the situation in which cancer has spread from another organ to the adrenal (metastatic spread)...with very few exceptions.

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