Adrenal Metastases
Cancer that has spread to the adrenal glands from elsewhere
Quick Facts
- Type: Secondary (metastatic) cancer
- Common origins: Lung, breast, kidney, melanoma
- Often found: On scans during cancer staging
- Hormone effect: Usually none, occasionally adrenal insufficiency
Overview
Adrenal metastases are cancer cells that have traveled to the adrenal glands from a primary tumor in another organ. The adrenal glands have a rich blood supply, which makes them a relatively common site for cancer to spread. Unlike a primary adrenal cancer, which begins in the gland itself, metastases originate elsewhere, most often in the lungs, breast, kidneys, or skin (melanoma).
Many adrenal metastases cause no symptoms and are discovered on imaging done to stage a known cancer. Their presence affects how the underlying cancer is treated, and management is guided by the type and extent of the original tumor.
Symptoms
Adrenal metastases frequently cause no symptoms of their own. When symptoms occur, they may include:
- Dull pain or discomfort in the side, back, or upper abdomen if a deposit grows large
- Fatigue and general signs related to the underlying cancer
- Unintended weight loss
- Rarely, symptoms of adrenal insufficiency if both glands are heavily affected, such as profound tiredness, low blood pressure, nausea, and salt craving
Sudden severe pain can occasionally result from bleeding into a deposit and should be evaluated promptly. Because the symptoms are often vague and overlap with those of the underlying cancer, adrenal metastases are frequently found through routine scans rather than because of specific complaints. Reporting any new or persistent symptoms to the cancer care team allows them to be checked.
Causes
Adrenal metastases are caused by the spread of cancer cells from a primary tumor through the bloodstream or lymphatic system to the adrenal glands. The cancers that most often spread there include:
- Lung cancer
- Breast cancer
- Kidney cancer
- Melanoma (skin cancer)
- Cancers of the colon, stomach, and other organs
The metastasis is made of the same type of cancer cell as the original tumor, which is why treatment is directed at the primary cancer.
Risk Factors
- Having a known cancer that commonly spreads, such as lung, breast, kidney, or melanoma
- Advanced or higher-stage primary cancer
- Factors that increase risk of the original cancer, such as smoking for lung cancer
Diagnosis
Adrenal metastases are usually found during evaluation of a known cancer or as an incidental adrenal mass on a scan.
- CT and MRI: Show the size and features of adrenal masses and help distinguish metastases from benign growths.
- PET scan: Can highlight active cancer throughout the body.
- Biopsy: A needle sample may be taken to confirm the diagnosis when it would change treatment, after first excluding a hormone-producing tumor.
- Hormone tests: Done to check adrenal function and rule out a secreting tumor before any biopsy.
- Comparison with prior scans: A new or growing adrenal mass in someone with cancer raises suspicion of metastasis.
Treatment
Treatment is guided primarily by the type and extent of the original cancer rather than the adrenal gland alone.
- Systemic therapy: Chemotherapy, targeted drugs, immunotherapy, or hormone therapy directed at the underlying cancer.
- Surgery: Removing the affected adrenal gland may be an option when the original cancer is controlled and the metastasis is isolated.
- Radiation therapy: Can shrink deposits or relieve pain in selected cases.
- Supportive care: Pain relief and management of any adrenal insufficiency.
An oncology team develops an individualized plan, and the goal may be to control the cancer, ease symptoms, and maintain quality of life. The presence of adrenal metastases usually means the cancer is at a more advanced stage, which influences the overall approach, but treatments have improved and many people live for a meaningful time with good symptom control. The specific plan depends heavily on the type of the original cancer, since some cancers respond well to targeted drugs or immunotherapy. Decisions are made together with the person and their care team, taking into account the goals of treatment, overall health, and personal preferences. Regular imaging is used to monitor how the deposits and the underlying cancer respond.
When to See a Doctor
People with a known cancer should keep all follow-up appointments so any spread can be detected and managed. Contact your care team if you develop:
- New or worsening pain in the side, back, or abdomen
- Severe fatigue, dizziness, or fainting
- Persistent nausea, vomiting, or unexplained weight loss
- Sudden severe abdominal or flank pain, which warrants urgent evaluation
Frequently Asked Questions
What does it mean if cancer has spread to the adrenal glands?
It means cancer cells from a tumor elsewhere have traveled to the adrenal glands, forming secondary deposits called metastases. This indicates the original cancer has spread beyond its starting point. Treatment is aimed at the underlying cancer type.
Are adrenal metastases the same as adrenal cancer?
No. Adrenal metastases come from a cancer that started in another organ, while primary adrenal cancer begins in the adrenal gland itself. They are made of different cell types and are treated differently.
Do adrenal metastases cause symptoms?
Often they cause no symptoms and are found on scans. Larger deposits can cause side or back pain, and rarely, if both glands are heavily affected, signs of adrenal insufficiency such as fatigue and low blood pressure. Report new or severe symptoms to your care team.
Can adrenal metastases be removed with surgery?
Sometimes. Surgery to remove the affected gland may be considered when the original cancer is well controlled and the adrenal deposit is isolated. The decision depends on the cancer type, overall health, and treatment goals.
How are adrenal metastases found?
They are usually discovered on CT, MRI, or PET scans performed to stage or monitor a known cancer. A biopsy may be done to confirm the diagnosis, after hormone tests rule out a hormone-producing tumor.
References
- National Cancer Institute (NCI). Metastatic Cancer.
- American Cancer Society. Adrenal Cancer.
- MedlinePlus, U.S. National Library of Medicine. Metastatic cancer.