For incidental nodules, give outpatient appt on discharge.
The biochemical work up needs to be done as an outpatient (not accurate in an acute setting-- false positives with several tests).
If logistically possible, order the following prior to specialty appointment:
1. Plasma fractionated metanephrines (on all pts)
2. Aldosterone and Plasma renin concentration (only if hypertensive)
3. Low dose dexamethasone suppression test (2mg dexamethasone at 11pm followed by an 8am blood draw for cortisol. Because of the nature of the timing, almost always has to be done at their home lab.
Adrenal Gland Incidentaloma Patient Education (See Krames)
What is it?
This is a tumor in an adrenal gland. These kinds of tumors
may be cancerous or non-cancerous. They are often found during imaging tests
and scans.
What should I know
about adrenal glands?
We all have 2 of them. They sit on top of each kidney.
They make hormones that your body needs. If they do not make
the right amount of hormones, you may feel sick.
Are there signs I have
these tumors?
The signs will depend on which hormones are made. Some
possible signs are:
·
Weight gain or loss
·
Skin has purple stretch marks
·
Skin is easy to bruise
·
Acne
·
Muscle weakness
·
Feeling tired
·
Problems sleeping
·
Depression or anxiety
·
For women, irregular periods or excess face or body hair
|
·
High blood pressure
·
High blood sugar
·
Bones less dense
·
Bad headaches
·
Sweating
·
Shakiness
·
Fast or irregular heartbeat
·
Pale face
|
What are types of these
tumors?
The type will depend on how the tumor affects the gland.
· Hormonally active or functional tumor. This
means it causes your adrenal glands to make too much of a hormone. This type of
tumor is called a hormonally active or functional tumor.
· Non-functional tumor. These
do not cause the glands to make too much of any hormone.
How will my doctor
evaluate my tumor?
Your doctor will look for the cause of the tumor and if it
affects your hormone levels. Your doctor may:
· Check
your medical history and family history
· Do a
physical exam
· Run blood,
urine, or genetic tests
How are these tumors
treated?
· No treatment. This
is true for most adrenal tumors.
· Surgery. Some tumors need to be
removed. This will depend on the type of tumor or if it affects your hormones.
· Hormone treatment.
· Genetic counseling.
Patients with an inherited tumor syndrome need this to make sure others in your
family are ok.
You may need regular check-ups with your doctor.
What are some questions
I should I ask my doctor?
· What
caused my tumor?
· What
tests do I need?
· What
are my options for treatment?
· What
are the risks and benefits of each treatment?
· How
long will I need treatment?
· How
often will I need check-ups?
To
schedule an appointment at UK Endocrinology clinic, call 859-323-2232.
