Adrenal Tumours

Many different kinds of tumours may develop in the adrenal gland. Because the gland has an endocrine function it often leads to hormone-producing tumours which are mostly benign. Adrenal cancer or metastases from other cancers are very rare. Therefore, the removal of an adrenal tumour is often indicated by the uncontrollable hormonal effects. For instance, severe hypertension (high blood pressure) develops in Conn’s disease, pheochromocytoma, and in adrenal Cushing syndrome. After surgery of the adrenal gland, the disease is cured and medication is no longer necessary.

Since the adrenal gland is a hormone-producing organ it is very important to treat patients in a multidisciplinary team together with an internist/endocrinologist, radiologist, pathologist, and a urologist/endocrine surgeon. The adrenal is a retroperitoneal organ (situated in the cavity where the kidney is, behind the abdominal organs i.e. intestine, stomach and liver). There are several different operating techniques to reach this space and minimally invasive surgery is the mainstay of treatment. Most of the time an open approach is not necessary anymore. Small openings in the abdominal wall of the patient are created for a laparoscopic approach. More recent techniques, like robotic surgery and retroperitoneal access, are further being developed making an individualized surgical approach possible. Occasionally, only in very large tumours and in adrenal cancer an open approach is performed.

The advantages of laparoscopic surgery are less pain, minimal blood loss, and fast recovery. Therefore, the patient can return to normal daily activities within a few weeks. Every patient fares well with an experienced adrenal surgeon and multidisciplinary team. Therefore, the ERN will provide the treating physician and patients with up-to-date knowledge and experience from experts in the field supported by multidisciplinary teams to improve the (surgical) outcome. The ones seeking medical advice will be sharing in the knowledge, that is based on current clinical guidelines and local experience, of European physicians working in acknowledged centres of expertise. These experts are constantly improving their skills by active involvement in international research and teaching programs. The ultimate goal of ERN is to reach the highest standard of care for every adrenal patient all around Europe.