Adrenal tumors that show no evidence of hormone production in patients without a history of malignancy are usually nonfunctioning adrenal adenomas. These benign tumors of the adrenal gland are more frequently detected, because of the increased use of computed tomography (CAT) scan and magnetic resonance imaging (MRI) in the evaluation of other medical conditions. When these adrenal tumors are noted on radiological studies, they are often not symptomatic because of their small size and may have never been noted without the radiology study.
The lack of hormone production should be confirmed for all adrenal tumors with blood and/or urine tests. As long as the tumor is small, nonfunctioning and has no features indicative of cancer, these tumors can be followed with repeat imaging studies in six months to a year.
Most small, nonfunctional adrenal adenomas do not require surgical removal, and patients will only need CAT scans or MRIs in the next six to 12 months to check for enlargement or changes. Larger nonfunctional adenomas or tumors that inhibit regular hormone function should be surgically removed, using minimally invasive or open surgical techniques.