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A Lump Showed Up on Your Abdominal CT Scan. Now What?

Your doctor sends you for a CT scan to evaluate a health concern, and the scan turns up a completely unrelated finding—a nodule or lump on your adrenal glands. Should you be worried?

Not necessarily. Here’s why. “Adrenal nodules are a common incidental finding on imaging, and their likelihood increases with age. By age 50, the likelihood of finding an adrenal nodule can be as high as 5%,” said I. Alex Bowman, MD, a medical oncologist at Banner MD Anderson Cancer Center at Banner Gateway Medical Center in Gilbert, AZ, who specializes in cancers of the urinary tract and genitals. “There is nothing you can do to prevent these nodules, and in most cases the cause is not known.”

A bit of background, in case it’s been a while since you took a biology class: Your adrenal glands sit on top of your kidneys. They make hormones that control your metabolism, blood pressure and stress responses. You’re probably familiar with the stress hormone adrenaline—its name comes from “adrenal.”

How to determine whether your adrenal nodule needs treatment

If you have an adrenal nodule, your doctor will consider several factors, such as its size, hormone production, or the likelihood that it’s cancerous, when making treatment recommendations:

  • Very small nodules, smaller than a centimeter, generally require no follow up.
  • Nodules from one to four centimeters are likely to be benign, but your doctor will probably recommend blood tests to check for excessive hormone production.
  • Nodules larger than four centimeters are more likely to produce excessive hormones or be cancerous. If CT or MRI scans suggest a cancerous tumor, or if you have excessive hormone production, your doctor will probably recommend surgery to remove the gland.

Nine out of 10 adrenal nodules are noncancerous. “Usually, these nodules are small and do not produce hormones, so they don’t cause any symptoms at all,” Dr. Bowman said. That’s why you didn’t suspect it was there.

What symptoms could point to an adrenal nodule?

Sometimes, though, these nodules do trigger symptoms. Up to 15% of benign nodules and most cancerous nodules can cause your adrenal glands to produce excessive hormones. In those cases, depending on which hormones are produced, you might notice symptoms such as:

  • Weight gain
  • Weakness
  • Acne
  • Increased hair growth on the face and body
  • Increased blood sugars
  • Very high blood pressure
  • Headaches
  • Heart palpitations

If you notice any of these symptoms, talk to your doctor. Tests and scans can help determine what’s causing them.

The bottom line

It’s common for adrenal nodules to turn up on imaging scans. Most of the time, they don’t cause symptoms and don’t need treatment. Your doctor can recommend tests to help determine whether your adrenal nodule needs further evaluation.

To learn more about kidney-related health issues, check out these articles:

Imaging Kidney