Adrenal Oncology

Adrenal tumors can be benign or malignant. Benign adrenal tumors can include adenomas and pheochromocytomas (neuroendocrine tumors). Malignant tumors include adrenocortical carcinoma. The Brigham and Women’s Hospital-Dana-Farber Cancer Center is a leading international referral center for patients with all types of adrenal tumors. We have the expertise to diagnose and treat neuroendocrine and adrenocortical tumors and function in multi-disciplinary teams for each tumor type.

Adrenocortical Tumors and Carcinoma

Adrenal tumors are common. Even though the majority of adrenal tumors are benign, some may overproduce hormones that contribute to disease, and rarely adrenal tumors may represent cancer. We recommend that all adrenal tumors undergo investigation to assess for hormonal overproduction and the potential for cancer. These investigations are conducted by our expert adrenal endocrinologists using blood and urine testing and imaging techniques. When indicated, adrenal tumors may need surgery.

Adrenal cancers are rare. However, adrenal cancers typically grow fast and overproduce many hormones that result in disease. Therefore, we recommend an aggressive and multi-disciplinary approach to diagnosing and treating adrenal cancers. This is achieved through our Adrenal Cancer Group which is comprised of a team of adrenal endocrinologists, adrenal surgeons, adrenal oncologists, as well as radiation oncologists, geneticists, and more. Together, this initiative provides patients with an expedited diagnostic work up and a cutting edge treatment plan.

Treatment plans include established therapies for adrenal cancer (such as surgery and mitotane), as well as new chemotherapies, immunotherapies, radiation therapies, interventional radiologic therapies, and clinical trials. In addition, the group routinely recommends novel genetic testing to assist with diagnosis and prognosis. A key characteristic of this multi-disciplinary and multi-institutional group is a dedication to research to develop better treatments for adrenal cancer and improve outcomes for patients with this disease.

Pheochromocytoma and Neuroendocrine Tumors

Patients with paraganglioma and pheochromocytoma face particular challenges, due to the rarity of their condition but also the complexity of their medical management, which requires expertise from multiple disciplines including medical endocrinologists, genetic counselors, surgeons, and medical oncologists.

Pheochromocytomas and paragangliomas are increasingly being recognized as part of a larger syndrome with a genetic root. Patients with these syndromes may develop tumors with the potential to produce active adrenaline-like products that contribute to high blood pressure and vascular disease. In rare cases, these tumors may be malignant.

Early recognition and treatment of these syndromes can substantially improve outcomes, and new advances in genetics can assist in identifying those at higher risk. Therefore, we have adopted a multi-disciplinary approach to pheochromocytoma-paraganglioma syndromes where endocrinologists, surgeons, and oncologists work together to provide patients with the optimal diagnostic and treatment plan. Treatment plans can involve medical therapies, surgical procedures, and systemic chemotherapies.

In addition, the Pheochromocytoma-Paraganglioma Genetics Group is a dedicated initiative involving adrenal endocrinologists, oncologists, surgeons, geneticists, and genetic counselors to provide patients access to new genetic technologies that can identify their risk, or a family member’s risk, for developing pheochromocytoma-paraganglioma syndromes.

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