Some of our friends will find adrenal tumors when they have a physical exam or have tests done for other reasons. Often, patients come to ask what is adrenal gland occupation? What is adrenal gland? What is the role of adrenal gland? What is adrenal tumor? What are the manifestations of adrenal tumor? How to diagnose adrenal tumor? How to treat adrenal tumor? I am here to answer for my patients. What is adrenal gland? Adrenal glands are a pair of endocrine glands and important endocrine organs in the human body, located in the upper medial part of the kidney, close to the upper pole of the kidney, one on each side. The adrenal glands can be divided into cortex and medulla. What is the role of the adrenal glands? The adrenal cortex secretes glucocorticoids such as cortisol, salt corticosteroids such as aldosterone, and sex hormones such as dehydroepiandrosterone and androstenedione. The adrenal medulla secretes catecholamines such as epinephrine, norepinephrine, and dopamine. Cortisol is secreted by the zona fasciculata of the cortex and is regulated by the hypothalamus (CRH)-pituitary (ACTH)-adrenal axis, which mainly regulates the metabolism of sugar, fat, and protein. Aldosterone is secreted by the globus pallidus of the cortex and is mainly regulated by the renin-angiotensin-aldosterone system. Its main role is to maintain normal blood volume and blood potassium concentration. Sex hormones are mainly secreted by the reticular band of the cortex. The adrenal glands produce 50% of the androgens in females and 2% of the androgens in males, which are important for the initiation of puberty. Adrenaline and norepinephrine can act on adrenergic receptors in the heart and blood vessels to regulate blood pressure and heart rate. What is an adrenal tumor? Adrenal tumors are tumors that occur on the adrenal glands, the vast majority of which are benign, and are also known as adrenal adenomas and adrenal tumors. on CT or ultrasound, they appear as an occupancy of the adrenal glands or retroperitoneal region, and so they can also be called adrenal occupancy. What are the manifestations of adrenal tumors? Some adrenal tumors do not secrete hormones and are often found on physical examination. Some of the adrenal tumors are relatively large in size and can produce occupying effects. There is also a part of adrenal tumors that can secrete the above mentioned hormones, causing various types of hormonal system disorders. For example, in patients with hypercortisolism, adrenal tumors can secrete a large amount of cortisol, resulting in metabolic disorders of sugar, fat and protein, also known as Cushing’s syndrome (Cushing’s syndrome). Patients can show full moon face, buffalo back, purple lines on the skin, weight gain, centripetal obesity, as well as high blood pressure and diabetes mellitus. In patients with primary aldosteronism, the adrenal tumor secretes large amounts of aldosterone, which manifests as hypertension and low blood pins. In patients with adrenal dysphoria syndrome, the adrenal tumor secretes a large amount of sex hormones, which may manifest as pseudohermaphroditism. In patients with pheochromocytoma, the adrenal tumor secretes catecholamines, which can cause secondary hypertension, which may manifest as paroxysms, and may appear as a triad of headache, palpitations, and excessive sweating. How to diagnose adrenal tumor? The diagnosis of adrenal tumor includes localization diagnosis and qualitative diagnosis. Localization diagnosis means to clarify the location of adrenal tumor through imaging methods, whether it is on the left side or right side, or bilateral. Commonly used are ultrasound, CT, MRI. Qualitative diagnosis refers to clarifying whether there is a hormone level disorder and which kind of hormone disorder through laboratory tests. How are adrenal tumors treated? Surgery is the most important treatment for adrenal tumors. The principle is to remove the tumor to the maximum extent while preserving the endocrine function of the organ. Non-functioning adenomas smaller than 4cm can be observed, but if the tumor grows more than 1cm within 1 year, surgery is still needed. Advanced adrenocortical carcinoma and malignant pheochromocytoma may not be surgically resectable. Adrenocortical carcinoma can be treated with mitotane, and malignant pheochromocytoma can be treated with MIBG or targeted drugs.