Adrenal nodules: Helping get a handle on hormones

Most nodules are harmless and do not cause problems. Unfortunately, serious consequences can result in a small number of cases if the nodule is not surgically removed.

UW Health offers an expert care team that can determine whether you will benefit from surgery. Most patients go home after one night and recover quickly. We’re there for you every step of the way.

The good news is that most adrenal nodules are harmless and, once checked out, do not need further medical treatment. Serious problems, however, can occur for the small number of patients who have a worrisome adrenal nodule.

If tests show that your adrenal nodule is problematic, rest easy. Our team of highly experienced endocrine surgeons are ready to take care of you. Surgery to remove an adrenal nodule will be recommended for one of two reasons:

• Your nodule is cancerous. Adrenal cancer is very rare but also aggressive.

• Your nodule is causing your adrenal gland to produce too much hormone, which can lead to serious issues (see below)

What adrenal gland hormones do why too much of them causes problems

• Cortisol. Cortisol is a stress hormone that regulates blood sugar and metabolism (process of turning food into energy). Patients can develop Cushing syndrome, often indicated by a fatty hump between the shoulders, unusual rounding of the face and pink or purple stretch marks. Other risks of excess cortisol include high blood pressure, weight gain, acne, muscle weakness, severe fatigue and irritability.

• Aldosterone. This hormone regulates blood pressure by managing sodium and potassium levels in your blood. Too much can cause the patient to have high blood pressure. Removing the adrenal nodule can restore normal blood pressure and, in certain cases, allow the patient to reduce or stop taking blood pressure medications.

• Adrenaline. Adrenaline is the "danger alert" hormone that causes the heart to beat faster and the lungs to breathe more efficiently in a stressful or dangerous situation. Excess levels can cause the patient to experience fast heart pounding, highly elevated blood pressure, sweating and headaches.

Diagnostic tests determine the best course of action

We determine whether surgery is necessary after obtaining urine samples and a blood draw from the arm. Blood draws can be done by most local primary care providers or at the UW Health Endocrine Surgery Clinic, located at the UW Health East Madison Hospital near the intersection of I-90 and Highway 151.

Chances are you will not need surgery, but if your result shows adrenal cancer or excessive adrenal hormone in your blood, we recommend removal of the troublesome adrenal nodule.

Typically, the endocrine surgeon uses a robot to remove the adrenal nodule with minimally invasive techniques. The location of the nodule will determine whether the surgeon chooses to access the adrenal gland through the patient’s front or back. Some post-surgical soreness is common, which can be treated with over-the-counter pain relievers.

Once you come home, you can expect to begin resuming normal routines within four to five days. Full recovery takes about 10 to 14 days.