What Blood Tests and Hormone Tests are Needed for Adrenal Tumors?
After performing a very careful interview with the patient to see if they have any symptoms as outlined above, the next step is to perform laboratory testing to see if the adrenal tumor is over producing any hormones. Knowing what hormone is being produced (if any), and how much is critically important. Unfortunately, testing for hormone production from adrenal tumors tends to confuse both patients and physicians--but it shouldn't. The reason is that very few doctors have significant experience with obtaining and interpreting laboratory values when it comes to adrenal hormones.
Blood Tests and Urinary Tests. The correct laboratory evaluation includes both urinary tests as well as blood tests because some of the adrenal hormones can build up in the blood while others build up in the urine. There are laboratory tests that are first done to screen for pheochromocytoma, Cushing’s syndrome and primary hyperaldosteronism (Conn’s syndrome). We discuss all of these tests in depth within the section dedicated to each adrenal tumor type. Sometimes these laboratory tests are unequivocal (i.e. the diagnosis is a slam dunk), and the patient can go straight to curative surgery (mini-back-scope adrenalectomy is always the preferred operation!).
Sometimes, however, these laboratory tests are borderline or difficult to interpret because of interference by medications. You can always contact us for us to review laboratory tests. This is all we do. For us it is very easy to evaluate laboratory testing since we have seen hundreds to thousands of adrenal patients. Sometimes when the laboratory tests are borderline they have to be repeated. In addition, there are some confirmatory test that needs to be performed. For a detailed discussion of laboratory (both blood, urine, and other tests) evaluation of each entity go to the individual pages of Pheochromocytoma, Cushing’s Syndrome, Primary hyperaldosteronism Conn's Syndrome, and Adrenocortical cancer.
Testing for sex hormone excess is also advocated by the European Society of Endocrinology who recommends testing for DHEA-S, androstenedione, 17-hydroxyprogesterone, testosterone for women, and estradiol for men and post-menopausal women if there are clinical signs of virilization or suspicion for adrenal cortical cancer.
Remember, if any adrenal tumor is producing hormone, or if it is more than 3-4 cm in diameter, the tumor needs to be removed surgically. For most patients, the Mini-Back Scope Adrenalectomy (the Mini-PRSA) is by far the best operation. Chose your surgeon wisely because your life may depend on it--Contact Dr Carling if you have any questions.