Adrenal nodule / adenoma found incidentally

What are the adrenal glands and what do they do?

You have two adrenal glands – one on top of each kidney. Your adrenal glands make several important hormones and if the adrenal glands make too much of any of these hormones you may develop health problems such as high blood pressure or diabetes. The names of the different hormones and the conditions they can cause will be explained to you at your appointment and you will have the chance to ask any questions at this time.

What is an adrenal nodule?

• Adrenal nodules are often detected by chance on a CT or MRI scan which has been carried out for other reasons.
• The most common type of adrenal nodule is an adrenal adenoma, which is a benign (i.e non-cancerous) lump found within the adrenal gland.
• If an adrenal adenoma produces excess hormones it is said to be ‘functioning’.
• If an adrenal adenoma does not produce any excess hormones, it is ‘non- functioning’.
• Less commonly, other types of nodules may arise within the adrenal gland – for example one that can over-produce adrenaline (so-called phaeochromocytoma).

Why am I having these tests?

These tests are used to determine whether the abnormality on your adrenal gland is producing any excess hormones (i.e. functioning).

If the levels of one or more adrenal hormones are increased, they may cause one or more of the following:

• High blood pressure.
• Low levels of a salt called potassium in the blood.
• If too much cortisol (a natural steroid) is being produced you could be diagnosed with a condition known as Cushing’s syndrome, this is the condition associated with over production of cortisol and can lead to changes in your appearance and how you feel, and may be associated with high blood pressure, diabetes and thin bones (osteoporosis).
• If there is over-production of adrenaline you may experience palpitations (fast heartbeat), sweating, tremors and panic attack type symptoms.

Who carries out these tests?

A nurse who specialises in endocrinology is responsible for carrying out these tests.

Where will these tests be carried out?

• You will be sent a letter giving you the details of where, when and what time to attend, it will accompany this information leaflet.
• You may wish to bring a companion with you and they may stay with you during these tests.

How long will the tests take?

You will be with us for about 30 minutes.

The specialist nurse will explain the tests to you and then they will take the blood tests, you may be given an additional blood test form and some dexamethasone tablets. The nurse will explain this test to you and how to carry it out and you will be able to ask any questions when you meet them.

Medication

Please bring a list of all of your medicines (including inhalers, injections, creams, eye drops or patches, or any herbal medications or other regular supplements) to the appointment.

When will I get the results?

The results of your test may take several weeks to be processed by the laboratory. The endocrine doctors will review them and depending on the results may ask the nurse to contact you to arrange some more tests. This will be explained to you during the appointment. If the tests show that the adrenal abnormality is not producing any hormones and there is no need for any further scans we will write to you to let you know that we can discharge you from our care (we will also write to your GP). If the adrenal abnormality appears to be making an excessive amount of one or more hormones, then you will be offered an appointment with an endocrine doctor to discuss the next steps. Similarly, you may be invited for a clinic appointment if there is any uncertainty as to the nature of the adrenal abnormality based on the scan appearance.

Contacts/further information

Endocrine Investigation Unit 01223 217848 – leave a detailed message on the voicemail which is regularly triaged for urgent enquiries.

General Information

Discounted parking is available for patients attending clinic appointments taking more than three hours. Please present your appointment letter to the car park attendant to receive this discount.

Food and drink – there is a coffee shop in the treatment centre atrium and further food and drink facilities in the main hospital concourse.