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Nonfunctional Adrenal Masses

By Ashley B. Grossman, MD, Emeritus Professor of Endocrinology, University of Oxford; Fellow, Green-Templeton College; Professor of Neuroendocrinology, Barts and the London School of Medicine; Consultant NET Endocrinologist, Royal Free Hospital, London

Nonfunctional adrenal masses are growths of the adrenal glands that have no hormonal activity.

Nonfunctional adrenal masses may be noncancerous growths or cancers. Some masses are cysts. Others are caused by bleeding or by infections.

Usually people have no symptoms unless the mass is caused by excessive bleeding, in which case people have abdominal pain and they may be weak or dizzy.

Often the masses are discovered when people have computed tomography (CT) or magnetic resonance imaging (MRI) for other medical problems. When a mass is found, doctors do blood tests to measure adrenal gland function.

Treatment depends on the size of the mass. Masses larger than about an inch and a half (4 centimeters) are usually taken out surgically. Masses smaller than about 3/4 inch (2 centimeter) are usually left alone and people have blood tests to detect whether the mass has started secreting excess hormones. People with masses in between those sizes have regular blood tests and also imaging tests to see whether the mass is growing. If a small mass grows to more than about 1½ inches (4 centimeters) or if hormone levels start to increase and cause symptoms, the mass may then be removed.