Adrenal Cancer: Diagnosis

How is adrenal cancer diagnosed?

If your healthcare provider thinks you might have adrenal cancer, you will need certain exams and tests to be sure. Diagnosing adrenal cancer starts with your healthcare provider asking you questions. He or she will ask you about your health history, your symptoms, risk factors, and family history of disease. Your healthcare provider will also give you a physical exam.

What tests might I need?

You may have 1 or more of the following tests:

• Blood tests

• Urine tests

• Chest X-ray

• Ultrasound

• CT scan

• MRI

• Nuclear imaging tests

• Biopsy

Blood and urine tests

Blood and urine hormone tests. These tests help check the amount of adrenal hormones in your bloodstream and urine. A 24-hour urine test may also be done. Your urine is collected for 24 hours to check the amounts of certain hormones. All of these tests can be very helpful in figuring out what kind of cancer you have.

Activating and inhibitory tests. You may also be given some medicines to increase or decrease the adrenal hormones. Blood or urine tests will then show if these hormone levels in your blood or urine have changed. Hormones made by a cancer tumor do not usually change with these medicines.

Imaging tests

Chest X-ray. This can  be done to see if the cancer has spread to your lungs.  It can also show if you have any lung or heart problems.

Ultrasound. This test uses sound waves and a computer to make pictures of parts of the body. This test may be used to see if an adrenal tumor is a fluid-filled sac (cyst) that is likely not cancer. It can also be used to see if a tumor is solid, which is more likely to be cancer. Ultrasound can also be used to estimate the size of a mass on the adrenal gland and check the liver for tumors.

CT scan. A CT scan uses a series of X-rays and a computer to make detailed images of the inside of the body.  CTs can measure tumor size well. A CT can suggest the density of the mass. This may help to figure out if the mass is cancer. 

MRI. An MRI uses magnets and radio waves to take pictures of the inside of the body. It does not use X-rays. MRIs can be used to check the brain and spine for problems.

Nuclear imaging tests. For these tests, mildly radioactive substances are given by a shot. They go into your blood stream and travel all over your body. The substance may be more likely to collect in cancer cells or in different types of adrenal tumors. The radiation can then be found with a special type of camera that shows where the tumors are. An MIGB scan is a nuclear imaging test used for adrenal cancer. MIGB is the radioactive material that's used. It collects in the tumor over 2 days. Scans are taken during this time. This test can help detect discern different types of adrenal tumors.

Biopsy

Biopsy. If your doctor finds something that may be cancer, a biopsy may be done. The doctor will take a small piece (called a sample) of the tumor using a thin needle. Sometimes a CT scan is used to guide the needle into the tumor. The sample is then checked under a microscope by a pathologist. This is a doctor who specializes in looking for disease. The pathologist looks at the cells to see if cancer is present.

Getting your test results

Your healthcare provider will contact you with your test results. Your provider will talk with you about other tests you may need if adrenal cancer is found. Make sure you understand the results and what follow-up you need.