Newspaper article The Florida Times Union

Causes Are Several for Enlarged Adrenal Gland

Newspaper article The Florida Times Union

Causes Are Several for Enlarged Adrenal Gland

Article excerpt

Byline: P. Douglas Filaroski, Times-Union staff writer

To submit a question, call Times- Union staff writer P. Douglas Filaroski at (904) 366-6228, fax to (904) 359-4478 or e-mail dfilaroski@jacksonville.com. Include your name, hometown and a phone number.

Question: What causes an adrenal gland to become enlarged?

B. Ivose

Jacksonville

Answer: There are two adrenal glands -- each located near the kidneys. Ordinarily they make three hormones, or chemical messengers, named cortisol, aldosterone, and epinephrine, or its relative norepinephrine. There are multiple causes of adrenal enlargement.

Important questions are: 1) Is one or are both of the adrenals enlarged? 2) Is there evidence of overproduction of one of the hormones made in the adrenal glands? 3) Is it malignant? Cancers that started someplace else can spread to the adrenals. In this case the primary cancer is almost invariably obvious and I will say no more about it. The most common cause of bilateral enlargement is congenital. You are born with it. Hyperplasia is a condition in which the adrenal glands have a hard time making enough cortisol so they enlarge to try to make a normal amount. Even this is quite rare.

Other causes can be infections like tuberculosis, or hemorrhages, bilateral tumors called pheochromocytomas most often seen in patients with a family history, and other rare things. If just one adrenal is enlarged, your doctor can often tell something more about it with a CT scan and occasionally an MRI although this test is not always necessary. Most often it is a benign fatty tumor called a myelolipoma. If not, then blood and a 24-hour urine collection is necessary to look for overproduction of one of the hormones mentioned above. If there is evidence of this, or if the mass is 4 centimeters (1.6 inches) or larger, then surgical removal is probably needed. …

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