Medical Oncologist
CION Cancer Clinics
Why an adrenal gland is removed | CION Cancer Clinics
An adrenal gland is removed when a tumour inside it is making too much hormone, when it looks like it could be a cancer, or, in selected cases, when a cancer from elsewhere has spread to it. A lump that does none of these is usually watched. This page explains each reason, what the team checks before recommending surgery, and who the operation does not suit. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
MI
Medically reviewed by Dr. Mohammed ImaduddinConsultant Surgical Oncologist · MBBS, MS (General Surgery), MCh (Surgical Oncology) · last reviewed September 2026, next review due September 2027
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On this page
- Why would a doctor remove an adrenal gland?
- Four kinds of adrenal problem that lead to surgery
- What the team checks before recommending surgery
- Words you will meet on your results, in plain language
- Four things families tell us, and what is actually true
- What this page cannot tell you
- Common questions about why an adrenal gland is removed
The short answer
Why would a doctor remove an adrenal gland?
An adrenal gland is removed for one of three reasons: a tumour in it is making too much hormone, a tumour in it looks like it could be a cancer, or a cancer from elsewhere has spread to it and taking it out would help. A lump that does none of these is usually watched, not operated on.
What the gland does
You have two adrenal glands, one above each kidney. They make cortisol, which manages stress and blood sugar; aldosterone, which balances salt and blood pressure; and adrenaline, which drives the fight-or-flight response. A tumour that pours out any one of these hormones can cause years of high blood pressure, weight gain, low potassium or frightening attacks of palpitations before anyone finds the cause.
Why removal, rather than tablets or watching
Tablets can dampen an overactive gland, but they do not stop the tumour growing and they carry their own side effects for life. Removing the gland ends the hormone excess at its source, and gives the laboratory the whole tumour to examine, which is the only way to know for certain what it was.
Many adrenal lumps are found by chance on a scan done for something else. Most of those are harmless and never need surgery.The reasons
Four kinds of adrenal problem that lead to surgery
The group your lump falls into decides how urgent the operation is and how much preparation it needs.
Too much cortisol
Called Cushing's syndrome when it comes from an adrenal tumour. It causes weight gain around the middle, a round face, thin skin, high sugar and high blood pressure.
Why surgery helps
- Stops the cortisol at its source
- The other gland is usually asleep, so tablets are needed for a while
Too much aldosterone
Called Conn's syndrome. It causes high blood pressure that resists several tablets, often with low potassium. Surgery is offered when the excess comes from one gland rather than both.
Why surgery helps
- Blood pressure often improves and tablets can be reduced
- Potassium usually returns to normal
Too much adrenaline
A phaeochromocytoma. It causes attacks of pounding heart, sweating, headache and sudden very high blood pressure. It needs weeks of medicine preparation before it is safe to operate.
Never removed as an emergency without preparation, unless there is no choice.A lump that could be a cancer
Adrenal cancers are rare, but the larger a lump is and the more irregular it looks on the scan, the more likely it is to be one. Here the gland is removed whole so the tumour is never opened.
Also in this group
- Lumps growing between scans
- A single spread from another cancer, in selected cases
Not sure whether this applies to you?
Ask an oncologistHow the decision is made
What the team checks before recommending surgery
Hormone tests
Blood and urine tests, sometimes over a day or two, to see whether the lump is making cortisol, aldosterone or adrenaline. Every adrenal lump gets these, even one found by chance, because a silent-looking tumour can still be active.
The scan features
A CT or MRI reads the size of the lump, how dense it is and whether it has smooth edges. Fatty, smooth, small lumps are almost always harmless. Large, dense or irregular ones raise concern.
A check for spread
If the lump looks suspicious, or if you already have another cancer, a PET-CT or further scans look for disease elsewhere before an operation is planned.
The tumour board
Surgeon, endocrinologist, radiologist and oncologist look at the results together. They weigh the hormone activity, the size, your other illnesses and your fitness for an anaesthetic.
The conversation with you
You are told what they think the lump is, what removal would achieve, what watching would mean, and what preparation is needed. That is the point to bring the family member who helps you decide.
On your report
Words you will meet on your results, in plain language
- Incidentaloma
- A lump found by accident on a scan done for another reason. The name says how it was found, not what it is.
- Functioning or non-functioning
- Whether the lump is making extra hormone. Functioning lumps are more likely to need removal, whatever their size.
- Adenoma
- A non-cancerous adrenal tumour. Most adrenal lumps are adenomas. Some make hormone and some do not.
- Adrenocortical carcinoma
- Cancer of the outer layer of the adrenal gland. Rare, and the main reason large or irregular lumps are removed rather than watched.
- Metanephrines
- The breakdown products of adrenaline, measured in blood or urine. A raised level points to a phaeochromocytoma.
- Suppression test
- A test where you take a tablet at night and have blood drawn in the morning, to see whether the gland switches off cortisol as it should.
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Commonly believed
Four things families tell us, and what is actually true
"If they want to remove it, it must be cancer."
Most adrenal glands are removed for hormone problems, not cancer. A tumour that keeps blood pressure dangerously high or floods the body with cortisol is worth removing even when it is completely benign. Ask your team which reason applies to you.
"It is small, so we can safely ignore it."
Size is only one of the signals. A small tumour that makes adrenaline can be more dangerous than a large one that makes nothing. Every adrenal lump needs hormone tests before anyone decides it can be left alone.
"Tablets can do the same job without an operation."
For some people they can, and for someone too frail for surgery they may be the right choice. But tablets do not shrink the tumour, they need lifelong monitoring, and they cannot tell you what the lump was. Removal answers that question.
"We should get it out this week."
For an adrenaline-producing tumour, rushing is the dangerous option. Weeks of medicine preparation come first. Even for a suspected cancer, completing the tests and planning the right operation matters more than a few days saved.
Being straight with you
What this page cannot tell you
This page cannot tell you whether your own lump should be removed. That depends on your hormone results, your scan features, your other illnesses and your own wishes, weighed by a team that has seen all of them.
Who surgery does not suit
A small lump that makes no hormone and looks harmless on the scan is usually watched with a repeat scan and repeat hormone tests, not removed. Someone whose heart or lungs would not cope with a general anaesthetic may be offered medicines to control the hormone instead. And where a cancer has already spread widely, removing the adrenal gland alone rarely helps, and other treatments come first.
Questions worth asking
Ask which of the three reasons applies to you. Ask what would happen if you waited, and how the team would know if waiting had stopped being safe. Ask whether the lump is making hormone, and whether you will need tablets after the gland is gone. Ask what preparation is needed and how long it takes. Write the answers down, because the appointment goes quickly.
If you have been told the lump is a phaeochromocytoma, do not let anyone operate without medicine preparation first. Ask about it directly.Questions we are asked
Common questions about why an adrenal gland is removed
My scan found an adrenal lump by chance. Does it need to come out?
Usually not. Most lumps found by chance are small, make no hormone and look harmless on the scan. Those are watched with a repeat scan and hormone tests. Removal is suggested when the tests show hormone excess, when the lump is large or irregular, or when it grows between scans.
Can an adrenal tumour cause high blood pressure?
Yes. Tumours that make aldosterone, cortisol or adrenaline all push blood pressure up, often in a way that does not respond well to ordinary tablets. If your pressure needs several medicines, or you have low potassium or attacks of palpitations, your doctor may test your adrenal glands for exactly this reason.
How do they know whether it is cancer before removing it?
They cannot be certain. The scan gives strong clues from size, density and edges, and hormone tests add to the picture. A needle biopsy is usually avoided for adrenal lumps because it can spread cells and is unsafe if the lump makes adrenaline. The pathology report after removal gives the final answer.
Will removing one gland leave me short of hormones?
In most people the remaining gland makes enough. The exception is after a cortisol-producing tumour, where the other gland has been switched off for months and needs time to recover. You would take steroid tablets meanwhile, and blood tests decide when to stop them. Only removal of both glands means lifelong tablets.
What if the cancer spread to the adrenal gland from somewhere else?
Removing the adrenal gland is sometimes offered when it is the only place a cancer has spread to, the original cancer is under control, and you are fit for surgery. It is not offered when there is disease in several places. Your oncologist and surgeon decide this together, case by case.
Is there any test that can replace surgery?
No single test tells you what an adrenal lump is with certainty. Scans and hormone tests get most of the way, and for harmless-looking lumps that is enough to justify watching. Where the results are worrying, removing the whole gland is both the treatment and the diagnosis.
My mother is elderly. Is she too old for this operation?
Age on its own is not the deciding factor. Fitness for a general anaesthetic, heart and lung health and how much the hormone excess is harming her matter more. For some older people medicines are the kinder option; for others removal takes away years of uncontrolled blood pressure. Ask for an honest assessment of both.
Who should I see first, a surgeon or an endocrinologist?
Either can start the process, and a good centre involves both. The endocrinologist sorts out the hormone tests and any preparation; the surgeon plans the operation. If you are unsure where to begin, send us your scan report and we will point you to the right specialist.
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Sources
- Cancer Research UK — Adrenal gland cancer
- National Cancer Institute — Adrenocortical Carcinoma Treatment (PDQ) - Patient Version
- NHS — Cushing's syndrome
- NHS — Phaeochromocytoma
- Cancer.Net (ASCO) — Adrenal Gland Tumor
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Adrenalectomy: What the Operation InvolvesWhat actually happens on the day and afterwardsPhaeochromocytoma: Why Preparation Is CriticalThe weeks of medicine that come before an adrenaline-producing tumour is removedAdrenal Metastases: When Surgery HelpsWhen spread to the adrenal gland is operated onDeciding on Cancer SurgeryHow to weigh any operation with your teamPET-CT scan guideThe scan used to check for spread before surgery
Talk to us
Not sure why surgery has been suggested?
Send us your scan and hormone reports or call the helpline. A surgical oncologist will explain which reason applies to you and what the options are. One helpline serves every CION centre.