Cortisol-Producing Tumors (Cushing's Syndrome)

Some adrenal tumors produce too much cortisol, a hormone that affects metabolism and helps the body recover from physical stress due to surgery, injury, and infection. An estimated 10 to 15 people out of a million, mostly between 20 and 50 years old, are diagnosed with this type of benign adrenal tumor each year.

Symptoms

Cortisol-producing tumors of the adrenal cortex can lead to Cushing’s syndrome, a disorder that is characterized by symptoms such as abdominal obesity, weight gain, rounded face, thinning of arms and legs, increased fat pad behind the neck, increased bruising, abdominal stretch marks, fatigue, muscle weakness, high blood pressure, low blood potassium levels, high blood sugar, depression, irregular menstruation, sexual dysfunction, and osteoporosis.

Diagnosis

An endocrinologist, surgeon, or other specialist can diagnose Cushing’s syndrome by reviewing the patient’s medical history, performing a physical examination, and administering laboratory tests to screen for excess cortisol with blood, urine, and saliva tests. If Cushing’s syndrome is confirmed, additional tests may be required to determine whether the condition is caused by an adrenal tumor, another medical condition (such as a pituitary tumor), or medications. Imaging with CT or MRI can be used to identify which adrenal gland is affected in patients with Cushing’s syndrome due to an adrenal tumor.

Treatment

Surgery is the primary treatment for patients with cortisol-producing adrenal tumors. After surgery, many patients need to take a cortisol-replacement medication such as hydrocortisone or prednisone until their remaining adrenal gland is able to produce sufficient levels of cortisol.