Symptoms of adrenal gland cancer

Last medical review:

Adrenal gland cancer may not cause any signs or symptoms in its early stages. Signs and symptoms often appear as the tumour grows or makes hormones that cause changes in the body. Other health conditions can cause the same symptoms as adrenal gland cancer.

The signs and symptoms of adrenal gland cancer may vary depending on:

  • whether the tumour is producing hormones (called a functional tumour) or not (called a non-functional tumour)
  • which hormones are overproduced
  • whether the tumour is large and pressing on nearby organs
  • whether the cancer has spread to other organs

Non-functional adrenal gland tumours usually don’t make any hormones and don’t cause any symptoms. They may cause symptoms only as they grow large and spread to other organs.

Functional adrenal gland tumours make too much of a certain hormone and cause symptoms. The symptoms will depend on which hormones are overproduced by the tumour. See your doctor if you have any of the following signs or symptoms.

Symptoms caused by too much cortisol

Adrenal gland tumours that make too much cortisol in the body cause Cushing syndrome (also called hypercortisolism). Cushing syndrome can also be caused by a pituitary gland tumour or drugs given to treat other health problems. Most people with a functional adrenal gland tumour develop Cushing syndrome. The signs and symptoms of Cushing syndrome include:

  • weight gain
  • a red, round and full face
  • muscle weakness
  • increased hair growth on the face and body
  • buildup of fat between the shoulders or above the collarbone
  • purple lines on the skin
  • high blood pressure
  • a high blood sugar (glucose) level
  • changes in mood and behaviour
  • weakening of bones (called osteoporosis)

Symptoms caused by too much aldosterone

Adrenal gland tumours that make too much aldosterone in the body cause Conn’s syndrome (also called primary hyperaldosteronism). The signs and symptoms of Conn’s syndrome include:

  • high blood pressure
  • muscle weakness
  • muscle cramps
  • increased thirst
  • frequent urination
  • a low level of potassium in your blood (called hypokalemia)
  • headaches that you feel in the front part of your head
  • abnormal sensations on the skin (called paraesthesia), such as numbness, prickling, tingling or burning
  • heart problems
  • vision problems

Symptoms caused by too much androgen or estrogen

Adrenal gland tumours that make too much of the sex hormones androgen and estrogen cause adrenogenital syndrome. The following are signs and symptoms of adrenogenital syndrome.

Too much androgen production in people assigned female at birth may cause:

  • excessive hair growth on the face, arms or upper back
  • acne
  • balding
  • deepening of the voice
  • no menstrual periods

Too much estrogen production in people assigned female at birth may cause:

  • irregular menstrual periods ( before menopause)
  • menstrual bleeding ( after menopause)

Too much estrogen production in people assigned male at birth may cause:

  • breast enlargement
  • decreased sex drive
  • erectile dysfunction

Too much androgen production in people assigned male at birth usually does not cause symptoms.

Symptoms caused by too much epinephrine or norepinephrine

Functional pheochromocytomas can make too much epinephrine or norepinephrine. High levels of these hormones can cause health problems. Signs and symptoms include:

  • high blood pressure
  • headache
  • sweating
  • rapid heartbeat

Symptoms caused by growth of the tumour

Signs and symptoms that can occur as the tumour grows larger or spreads to other parts of the body include:

  • pain in the abdomen or back
  • feeling of fullness in the abdomen
  • a lump in the abdomen
  • feeling full sooner than normal after eating, or feeling full after eating less than usual
  • pain and difficulty urinating
  • swelling of the legs
  • nausea and vomiting
  • constipation

Expert review and references

  • Shereen Ezzat, MD, FRCPC, FACP
  • American Cancer Society. Adrenal Cancer. 2018. https://www.cancer.org/.
  • American Society of Clinical Oncology (ASCO). Cancer.net: Adrenal Gland Tumor. 2022.
  • American Society of Clinical Oncology (ASCO). Cancer.net: Pheochromocytoma and Paraganglioma. 2022.
  • Fassnacht M, Dekkers O, Else T, et al. European Society of Endocrinology clinical practice guidelines on the management of adrenocortical carcinoma in adults, in collaboration with the European Network for the Study of Adrenal Tumors. European Journal of Endocrinology. 2018: 79(4):G1–G46.
  • National Organization for Rare Disorders. Pheochromocytoma/Paraganglioma. 2021. https://rarediseases.org/.
  • O'Leary C, Birkhimer D. Endocrine malignancies. Yarbro CH, Wujcik D, Gobel B (eds.). Cancer Nursing: Principles and Practice. 8th ed. Burlington, MA: Jone & Bartlett Learning; 2018: Kindle version, chapter 52, https://read.amazon.ca/?asin=B01M6ZZEWT&ref_=kwl_kr_iv_rec_1.
  • PDQ Adult Treatment Editorial Board. Adrenocortical Carcinoma Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2022. https://www.cancer.gov/.
  • PDQ Adult Treatment Editorial Board. Pheochromocytoma and Paraganglioma Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2022. https://www.cancer.gov/.
  • National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Neuroendocrine and Adrenal Tumors Version 1.2023. 2023.
  • Pheochromocytomas/paragangliomas. Site Group: Endocrine. Princess Margaret Cancer Program Clinical Practice Guidelines. University Health Network; 2019. https://www.uhn.ca/PrincessMargaret/Health_Professionals/Programs_Departments/Pages/default.aspx.
  • Stewart AA, Story ES. Adrenal neoplasms. Raghavan D, Ahluwalia MS, Blanke CD, et al, eds.. Textbook of Uncommon Cancer. 5th ed. Hoboken, NJ: Wiley Blackwell; 2017: Kindle version, 47, https://read.amazon.ca/?asin=B06XKD44V3&_encoding=UTF8&ref=dbs_p_ebk_r00_pbcb_rnvc00.

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