Abdomen, Pelvis, and Perineun

Adrenal Adenoma

An adrenal adenoma is a benign tumor of the adrenal gland that can secrete various hormones, depending on whether it is a functioning or non-functioning adenoma. Here are the hormones that an adrenal adenoma may secrete:

1. **Cortisol**: If the adenoma secretes excess cortisol, it can lead to Cushing's syndrome. Symptoms of Cushing's syndrome include weight gain, especially around the abdomen and face, thinning skin, easy bruising, high blood pressure, and high blood sugar levels.

2. **Aldosterone**: If the adenoma secretes excess aldosterone, it can cause a condition known as primary aldosteronism or Conn's syndrome. This condition can lead to high blood pressure, low potassium levels, muscle weakness, and fatigue.

3. **Androgens (e.g., testosterone)**: Although less common, some adrenal adenomas can secrete androgens. Excess androgen production can cause symptoms such as increased body hair, acne, and menstrual irregularities in women.

Non-functioning adrenal adenomas do not secrete hormones and are often asymptomatic. They are usually discovered incidentally during imaging studies for other conditions. If a non-functioning adenoma is found to be large or shows signs of growth, it may be monitored or surgically removed to rule out malignancy.

Clinical Findings and Diagnostic Criteria
Management & Treatment
Pathology
Etiology
Pathogenesis
Pathophysiology
Epidemiology
Prevention
Complications
Prognosis
Research Frontier
Clinical Case Studies
Study Questions

Symptoms

Most do not cause any symptoms.

Some maybe "functioning" which means they produce hormones, often in excess of what the adrenal glands typically produce. High levels of these hormones can lead to complications, including primary aldosteronism and Cushing's syndrome.

Signs

Most do not cause any signs.

Functioning adrenal adenomas

surgery

medications.¹

Adenomas of the adrenal gland are non-cancerous (benign) tumors on the adrenal gland.

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Complications of Injecting Drug Use

Local problems—Abscess (Figures 240-2

A 32-year-old woman with type 1 diabetes developed large abscesses all over her body secondary to injection of cocaine and heroin. Her back shows the large scars remaining after the healing of these abscesses. (Courtesy of Richard P. Usatine, MD.)

and 240-3; Abscess), cellulitis, septic thrombophlebitis, local induration, necrotizing fasciitis, gas gangrene, pyomyositis, mycotic aneurysm, compartmental syndromes, and foreign bodies (e.g., broken needle parts) in local areas.2
- IDUs are at higher risk of getting methicillin-resistant Staphylococcus aureus(MRSA) skin infections that the patient may think are spider bites (Figure 240-4).
- Some IDUs give up trying to inject into their veins and put the cocaine directly into the skin. This causes local skin necrosis that produces round atrophic scars (Figure 240-5).
IDUs are at risk for contracting systemic infections, including HIV and hepatitis B or hepatitis C.
- Injecting drug users are at risk of endocarditis, osteomyelitis (Figures 240-6and 240-7), and an abscess of the epidural region. These infections can lead to long hospitalizations for intravenous antibiotics. The endocarditis that occurs in IDUs involves the right-sided heart valves (see Chapter 50, Bacterial Endocarditis).2 They are also at risk of septic emboli to the lungs, group A β-hemolytic streptococcal septicemia, septic arthritis, and candidal and other fungal infections.

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