Adrenal Gland Disorders
At Mount Sinai, we have a rich history of caring for patients with adrenal disorders, which are complex conditions that require coordinated care by various specialists. Our surgeons have the unique opportunity to collaborate with endocrinologists, cardiologists, radiologists, interventional radiologists, neurosurgeons, nuclear medicine physicians, and geneticists to conduct a comprehensive evaluation of your case and develop a treatment plan for you based on your individual needs. We all meet to discuss your treatment before and after your operation to provide you the most comprehensive and effective treatment.
About Adrenal Glands
Your body has two adrenal glands sitting on top of your kidneys. The adrenal glands produce a variety of important hormones, including cortisol (helps the body to respond to stress and metabolism), aldosterone (helps control blood pressure, balancing electrolytes, sodium, and potassium), and androgens (important in testosterone production). The adrenal glands also produce catecholamines (epinephrine and norepinephrine) which are hormones that contribute to your body’s involuntary flight or fight response to rigorous activity and stress.
The hormones produced by the adrenal gland are essential to your body’s normal function. Fortunately, you can function with one adrenal gland if the other one needs to be removed surgically because it is diseased. In select cases, we may perform adrenal-sparing surgery, and in other cases, we may need to remove both adrenal glands followed by medical replacement of essential hormones.
Adrenal Gland Conditions We Treat
Adrenal nodules may be hyperfunctiong (making excess hormone) or non-functioning (hormone levels not elevated). While medications can sometimes control excess adrenal hormone production, most often surgery is the only cure.
We treat all conditions of the adrenal glands, including:
- Non-functioning adrenal nodules that are larger than 6cm, experience a rapid growth, or with a suspicion or risk factor for adrenal cancer.
- Adrenal cancer—uncommon malignant cells that form a growth on adrenal glands that may over produce hormones and cause sudden symptoms and possibly, Cushing syndrome.
- Adrenal incidentaloma—tumor discovered incidentally during CT scan or MRI screenings performed to diagnose an unrelated condition. May affect one or both adrenal glands without any symptom or negative effect; requires treatment when the tumor grows large or produces excess hormones.
- Aldosternomas—benign tumors on one or both adrenal glands causing overproduction of aldosterone that leads to high blood pressure and low potassium levels in the blood with symptoms that include muscle cramps and weakness.
- Cushing disease and syndrome—caused by overproduction of cortisol that may be associated with benign or malignant adrenal gland conditions and tends to cause various bodily symptoms, including weight gain, easy bruising, as well as diabetes and susceptibility to infection.
- Pheochromocytoma—rare tumor of the adrenal gland tissue overproducing hormones that control heart rate, metabolism, and blood pressure. May cause dangerously high blood pressure that can lead to stroke and heart attack if left untreated. Surgical removal of these tumors can prevent serious complications and save your life. After surgery, lifelong monitoring is necessary. We have a skilled anesthesia team who specializes in administering anesthesia in patients with pheochromocytoma.
Adrenal Gland Treatments We Provide
To treat most adrenal tumors, we remove the tumors using minimally invasive techniques, and when necessary we use an open procedure. Our Mount Sinai surgeons offer a wide variety of approaches that we tailor to your individual needs in order to provide you the best possible outcome. Our team of expert endocrinologists, surgeons and other specialists work together to implement a comprehensive care plan just for you.
When possible, we offer adrenal-sparing surgery, but some conditions may require removal of both adrenal glands. If your condition does not meet criteria for adrenal-sparing surgery, we offer adrenal autotransplantation—replacing adrenal gland tissue to maintain hormone production in the hopes of avoiding the need for lifelong medication.
Surgery for adrenal cancer
Our surgeons use personalized, minimally invasive and open surgical approaches to treat adrenal disorders, which include:
- Laparoscopic transabdominal approach—small incisions are made in the abdomen to access the adrenal glands
- Laparoscopic retroperitoneal approach—small incisions are made on the back to gain access to the adrenal glands
- Robotic transabdominal approach—small incisions are made in the abdomen to access the adrenal glands and the surgeon uses the arms of a surgical robot to perform the surgery.
- Standard transabdominal approach—small incisions are made on the front of the abdomen
- Direct retroperitoneal approach—incisions are made on the back
Recovery and post-operative support
If you are like the majority of patients, you will stay only overnight or go home the same day after adrenal surgery. However, if you are treated for pheochromocytoma, you may need to stay in a monitored setting until your blood pressure normalizes.
Our surgeons are available 24/7 to support you during your recovery.