Should an adrenal tumor be biopsied?

Steven G. Eisenberg, DO
Hematology & Oncology

The cells obtained by a needle biopsy of an adrenal tumor CANNOT tell the pathologist whether the tumor is a benign adrenal mass or a rare adrenal carcinoma. It will only help in determining a primary adrenal tumor (started in the adrenal) versus metastatic tumor (one that traveled to the adrenal gland). Most commonly, a biopsy is done if there is evidence of cancer outside the adrenal gland, or a patient with a known cancer (such as lung cancer) has a suspicious adrenal mass. We must also exclude a pheochromocytoma with biochemical testing prior to a biopsy.

Ajay K. Sahajpal, MD
Transplant Surgery
No. In general, an adrenal tumor should not be biopsied until a full hormonal/biochemical or functional work up has been done by either the endocrinologist, surgeon or primary MD. If a diagnosis can't be made after that and it is clear that the tumor is not functional or producing hormones than a multidisciplinary tumor board can discuss a biopsy.
One common mistake is to perform a biopsy when an adrenal tumor is discovered. This can be disastrous if the tumor is a pheochromocytoma. Adrenal masses should never be biopsied unless a pheochromocytoma has been ruled out with biochemical tests. Even then, a biopsy is rarely helpful or necessary. The main reason to biopsy an adrenal mass is to make a diagnosis of an adrenal metastasis in someone with another type of cancer for whom the physician is deciding between systemic therapy and surgery. An example of this is someone with lung cancer and an adrenal tumor. If the adrenal tumor is a metastatic lung cancer, the patient will likely get chemotherapy and not an operation to remove the lung cancer. 

Continue Learning about Endocrine System

Endocrine System

Your endocrine system works with your nervous system to control important bodily functions. The endocrine systems responsibilities include regulating growth, sexual development and function, metabolism and mood. The endocrine syst...

em also helps give your body the energy it needs to function properly. Endocrine glands secrete hormones into the bloodstream. Hormones are considered chemical messengers, coordinating your body by transferring information from one set of cells to another. Your endocrine system health can be affected by hormone imbalances resulting from impaired glands. A hormone imbalance can cause problems with bodily growth, sexual development, metabolism and other bodily functions. Endocrine system diseases or conditions include diabetes, growth disorders and osteoporosis.

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.