SURGICAL ADRENAL CONDITIONS

Understanding the Adrenal Glands

The adrenal glands are two small, triangular-shaped organs located above each kidney. Though small in size, they are powerful endocrine organs responsible for producing essential hormones such as:

  • Cortisol – the body’s stress hormone

  • Aldosterone – regulates blood pressure and salt balance

  • Adrenaline and noradrenaline – help respond to stress

  • Sex hormones – such as androgens (in small amounts)

Surgical Adrenal Conditions

Adrenal Adenoma:
A benign tumour of the adrenal gland. Most are non-functioning and discovered incidentally on scans (so-called "incidentalomas"), but some produce excess hormones and require treatment.

Pheochromocytoma:
A rare tumour that produces excess adrenaline, causing episodes of high blood pressure, headaches, palpitations, sweating, and anxiety. Untreated, it can be dangerous.

Cushing’s Syndrome:
Caused by an adrenal tumour producing too much cortisol. Patients may experience weight gain (especially in the face and abdomen), thinning skin, easy bruising, fatigue, and high blood sugar.

Conn’s Syndrome (Primary Hyperaldosteronism):
Caused by an overproduction of aldosterone, leading to high blood pressure and low potassium levels. Surgery is often curative for unilateral cases.

Adrenal Cancer:
A rare and aggressive tumour requiring urgent surgical removal, often with additional treatments depending on the stage and spread.

Diagnosis and Assessment

Diagnosing adrenal conditions — particularly those involving hormone overproduction — requires a high degree of diligence, experience, and attention to detail. Many adrenal disorders, such as Cushing’s syndrome, primary aldosteronism, or pheochromocytoma, present with subtle and non-specific symptoms. These changes often develop insidiously over months or years, and are frequently mistaken for common lifestyle-related issues such as high blood pressure, weight gain, fatigue, or anxiety.

Because of this, adrenal hyperfunction is often underdiagnosed or misattributed to other causes. I take great pride in conducting a comprehensive and systematic assessment, starting with a thorough history and physical examination, followed by targeted biochemical testing, hormonal profiles, and high-resolution imaging.

Every case is reviewed meticulously — I go through each result with a fine-tooth comb to ensure that no detail is overlooked and that any diagnosis is both accurate and meaningful. My goal is not just to name the condition, but to identify those patients who will truly benefit from surgery with real, long-lasting improvements in their health and quality of life.

In appropriate cases, surgical removal of the adrenal gland (adrenalectomy) can lead to significant and often curative changes — such as resolution of hypertension, correction of hormonal imbalances, or prevention of serious complications.

Blog: Adrenal Gland Surgery

When is Adrenal Surgery Needed?

Surgery is generally recommended when:

  • The adrenal tumour is producing excess hormones

  • The adrenal adenoma is larger than 4–5 cm (higher risk of cancer)

  • There is radiological concern for malignancy

  • The tumour is producing local pressure symptoms

For a detailed discussion of surgical approaches to adrenal conditions — including the state-of-the-art retroperitoneal endoscopic adrenalectomy — please refer to my dedicated blog on this topic.