Adrenal Gland Expertise: Adrenal Tumor Diagnosis and Adrenal Surgery
Adrenal Tumor and Adrenal Surgery Advice From the Team at the Carling Adrenal Center
Adrenal.com is a leading patient resource for adrenal gland function, adrenal gland tumors, adrenal cancers and adrenal gland surgery. The diagnosis and surgical treatment of all types of adrenal tumors are discussed. The site is written and maintained by the team at the Carling Adrenal Center, one of the highest-volume adrenal surgery centers in the world, and its well-organized pages cover all adrenal topics. Our founder, Dr. Tobias Carling, has performed thousands of adrenal operations over his career, including more than 2,400 since January 2022 alone, and has published widely on adrenal disease and adrenal surgery. Last updated: October 2026
The adrenal glands are located on the top of the kidney on both sides of the body.
What are Adrenal Glands?
Adrenal glands are orange-colored glands that are located on the top of both kidneys. Adrenal glands are about the size and shape of fortune cookies, sitting on top of the kidneys like hats. Everyone has two adrenal glands that make several important hormones that are required for healthy life. Many adrenal tumors make no hormones and only need to be tested and watched, and some adrenal conditions are treated with medication. Most hormone-producing adrenal tumors, however, are treated with surgery to remove the tumor that is causing a very specific hormone problem. Return to this Home Page or use the navigation menu or the search box to find topics.
Section 1: Introduction to Adrenal Glands
What are Adrenal Glands? The basics of adrenal glands and an overview of the medical conditions they cause.
Normal Adrenal Gland Function. Adrenal glands make several different hormones, including cortisol, aldosterone and adrenaline, that help control blood pressure, blood sugar and the salt balance in your blood.
Adrenal Gland Anatomy. Learn how adrenal gland anatomy makes adrenal surgery an operation for experts.
Common Adrenal Problems A quick look at the most common adrenal problems and how they are treated.
State-of-the-Art Treatments An overview of the treatment options for adrenal tumors and why a surgeon who performs adrenal surgery regularly gives you the best chance of a good outcome.
About the Carling Adrenal Center. The Carling Adrenal Center is one of the highest-volume adrenal surgery centers in the world. About half of our patients come from outside Florida, including from around the world.
Become our Patient. You can have Dr. Carling perform your adrenal operation. Dr. Carling personally performs every operation at the Carling Adrenal Center, which amounts to about one in eight adrenalectomies in the United States.Section 2: Adrenal Gland Tumors
Adrenal tumors can cause many different symptoms. Cross-section of a typical adrenal adenoma (arrow). It has a typical yellow-orange color. This tumor caused adrenal hypercortisolism (too much cortisol; adrenal Cushing syndrome).
Overview of Adrenal Gland Tumors. A beginner's look at adrenal tumors.
Symptoms of Adrenal Gland Tumors. Specific symptoms caused by the different adrenal conditions and adrenal tumors.
High Blood Pressure and Adrenal Tumors. Learn how hormone-producing adrenal tumors cause high blood pressure.
Lab and Blood Testing of Adrenal Tumors. We test the function of the adrenal glands and adrenal tumors by measuring different adrenal hormones.
Scans Used for Adrenal Tumors. The different types of CT scans, MRI and other scans used to evaluate adrenal glands and adrenal tumors.
Adrenal Incidentalomas. Adrenal tumors (adrenal nodules or adenomas) that were found by "surprise" when a CT scan or other scan of the abdomen or back was performed for some other reason. Every one of them needs hormone testing.
Risks of Cancer in Adrenal Tumors. Most adrenal tumors are benign, but some are malignant.
Section 3: Surgery for Adrenal Gland Tumors
Mini Back Scope Adrenalectomy (MBSA). Also called Minimally Invasive Back Scope Adrenal Surgery or Mini-Posterior Retroperitoneal Scope Surgery. We believe this minimally invasive operation is the best adrenal operation for most adrenal tumors, and we use it for more than 95% of our operations.
Advantages of Mini Back Scope Adrenalectomy (MBSA). A close look at the many benefits of this advanced minimally invasive adrenal operation. In our experience it is faster and gentler than other adrenal operations, including robotic adrenal surgery, which in our view adds cost without benefit (we do not perform robotic adrenal operations). Ask your surgeon how many adrenal operations they perform each year and by which approach.
The 8 Types of Adrenal Surgery. Learn about the 8 different ways that a surgeon can remove an adrenal tumor--some are out of date. See why Dr. Carling prefers the Mini Back Scope Adrenalectomy (MBSA) for most patients.
Partial Adrenalectomy: The Adrenal-Sparing Operation. In selected patients, especially those with tumors in both adrenal glands, we save part of the adrenal gland and remove only the adrenal tumor--not the entire gland. This can avoid lifelong steroid dependence. Read more about partial adrenal surgery on our adrenal surgery blog
Open Trans-Abdominal Adrenal Surgery. Operating through the abdomen is a bigger operation. Today it is reserved mainly for known or suspected adrenal cancers and very large tumors.
The Basics of Adrenal Surgery. An overview of the tricky nature of adrenal surgery.
Become our Patient. Instructions on how to become our patient at the Carling Adrenal Center and have Dr. Carling, one of the world's most experienced adrenal surgeons, perform your operation. Your health and safety are worth a trip to Tampa.
Section 4: Primary Aldosteronism (Conn's Syndrome): Aldosterone-Secreting Tumors
Introduction to Primary Aldosteronism (PA). Also called Conn's syndrome, Conn syndrome or primary hyperaldosteronism: the adrenal glands make too much of the hormone aldosterone. PA affects an estimated 5–20% of people with high blood pressure, yet fewer than 1% of cases are diagnosed.Symptoms of Primary Aldosteronism. High blood pressure is often the only sign. Most patients have a normal potassium level and many have no other symptoms.
Diagnosis and Testing for Primary Aldosteronism. Everyone with high blood pressure should be screened with a simple blood test for aldosterone and renin. A CT scan identifies the source in many patients; some also need adrenal vein sampling (AVS).
Adrenal surgery scar: Small Steri-strips (thin adhesive strips) after Right Mini Back Scope Adrenalectomy; MBSA.
Complications of Primary Aldosteronism. Untreated PA carries a much higher risk of stroke, heart attack and atrial fibrillation than ordinary high blood pressure of the same severity. When one adrenal gland is responsible, a Mini Back Scope Adrenalectomy (MBSA), which typically takes 20 to 30 minutes, corrects the aldosterone excess in the large majority of patients.
Scans to Find the Source of Primary Aldosteronism. A correctly done CT scan finds many aldosterone-producing adrenal tumors, although small ones can be missed.
Surgery for Primary Aldosteronism (Conn's Syndrome). Most aldosterone-producing tumors can be removed with a Mini Back Scope Adrenalectomy (MBSA). Medication is a good option for mild PA and for many patients with PA in both glands.
AVS and surgery in one trip. Not every patient with PA needs adrenal vein sampling. For selected patients who do, it is feasible to have adrenal vein sampling and adrenal surgery in a single trip to Tampa. This requires several days in the Tampa area because of the turnaround time of the aldosterone assays.
Section 5: Adrenal Hypercortisolism (AHC): Cortisol-Secreting Adrenal Tumors
Introduction to Adrenal Hypercortisolism (AHC). Too much cortisol from an adrenal tumor, formerly called MACS (mild autonomous cortisol secretion) or subclinical Cushing syndrome; severe AHC is adrenal Cushing syndrome. AHC is the most common hormone problem found in adrenal tumors.
Symptoms of Adrenal Hypercortisolism. Most patients do not have the classic Cushing appearance. High blood pressure, diabetes or prediabetes, weight gain and bone loss or fractures are the usual clues.
Diagnosis and Testing for Adrenal Hypercortisolism. The key test is the 1-mg overnight dexamethasone suppression test: a cortisol above 1.8 µg/dL the next morning is abnormal. ACTH and DHEA-S blood tests support the diagnosis.
Surgery for Adrenal Hypercortisolism. Adrenalectomy is the only cure. In mild AHC the decision is individualized, and when both glands are involved, adrenal-sparing surgery can avoid lifelong steroid dependence.
Section 6: Pheochromocytomas: Adrenaline-Secreting Tumors of the Adrenal Medulla
Introduction to Pheochromocytomas. Pheochromocytomas (Pheos) are tumors that grow from the central part of the adrenal gland (the medulla). About 30–40% are hereditary, so genetic testing should be offered to every patient.Symptoms of Pheochromocytomas. Pheochromocytomas typically cause symptoms intermittently, but the symptoms and high blood pressure can be extreme.
Diagnosis and Testing for Pheochromocytomas. A blood or 24-hour urine test for metanephrines and a CT scan can diagnose most pheochromocytomas.
Scans to Find the Pheochromocytoma. Most pheochromocytomas within the adrenal or outside the adrenal (called paragangliomas) can be found with a correctly performed CT scan.
Pheochromocytomas in Children and Teenagers. Although uncommon, pheochromocytomas do occur in children, providing special challenges.
Become Our Patient. Patients travel from around the world to have adrenal surgery with Dr. Carling.
Become Our Patient
Patients needing adrenal surgery travel from all over the world to have adrenal surgery with Dr. Carling, one of the world's most experienced adrenal surgeons. This page discusses how you can have your adrenal operation at the Carling Adrenal Center with Dr. Carling himself.What to read next
- Mini Back Scope Adrenalectomy (MBSA) - our preferred adrenal operation, used for more than 95% of our operations.
- More about our founder Dr. Tobias Carling - one of the world's most experienced adrenal surgeons.
- How to become our patient, and have Dr. Carling perform your adrenal surgery.
- The 8 ways adrenal surgery can be performed - learn about the different types of surgery and when they are appropriate.