Diagnosis

Doctors use many tests to diagnose a tumor and determine if it has metastasized. Some tests may also determine which treatments may be the most effective. To diagnose an adrenal gland tumor, blood and urine tests (see below) are done to look for certain substances that may indicate that cancer is present. If the doctor suspects that the cancer has spread from another area of the body, a biopsy may be performed to determine the type of cancer. If a biopsy is not possible, the doctor may suggest other tests that will help make a diagnosis. Imaging tests may be used to find out whether the cancer has metastasized. Your doctor may consider these factors when choosing a diagnostic test:

• Age and medical condition
  
  
• The type of tumor suspected
  
  
• Severity of symptoms
  
  
• Previous test results

In addition to a physical examination, the following tests may be used to diagnose an adrenal gland tumor:

Blood and urine tests. Blood tests can measure the amounts of natural hormones produced during stress, such as catecholamines and metanephrines, which can detect a functional tumor. A patient may be asked to take a pill on the evening before the blood and urine tests, which helps detect the normal suppression of production of the hormone cortisol. A 24-hour urine sample, which requires the collection of all urine during that timeframe for laboratory testing, may also be necessary. This helps the doctor track how quickly various hormones are produced. Tell your doctor about any medications that you take, even over-the-counter drugs, because this information is needed to correctly interpret the results.

Biopsy. A biopsy is the removal of a small amount of tissue for examination under a microscope. For an adrenal tumor, a hollow needle is used to collect the tissue. Other tests can suggest that cancer is present, but only a biopsy can make a definite diagnosis. The sample removed during the biopsy is analyzed by a pathologist (a doctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease).

Computed tomography (CT or CAT) scan. A CT scan creates a three-dimensional picture of the inside of the body with an x-ray machine. A computer then combines these images into a detailed, cross-sectional view that shows any abnormalities or tumors. Sometimes, a contrast medium (a special dye) is injected into a patient’s vein to provide better detail.

Magnetic resonance imaging (MRI). An MRI uses magnetic fields, not x-rays, to produce detailed images of the body. A contrast medium is injected into a patient’s vein to provide better detail.

Metaiodobenzylguanidine (MIBG) scan. MIBG is a chemical similar to adrenaline that will collect in a neuroendocrine tumor. A MIBG scan can show a tumor of the adrenal medulla that may not appear in an x-ray. The scan takes place over two consecutive days. On the first day, an injection of MIBG is given in the arm. Several hours later, pictures are taken with a special camera that can detect if or where in the body the MIBG has collected. The following morning, more pictures are taken, and the process may be repeated if necessary.

To learn more about what to expect during common diagnostic tests, read Cancer.Net: Tests and Procedures.

To learn about the terms used in this section, read the Cancer.Net Feature: Cancer Terms to Know: Newly Diagnosed.