This page was reviewed under our medical and editorial policy by
Chukwuemeka Obiora, MD, Surgical Oncologist
This page was reviewed on March 17, 2023.
You have two adrenal glands. One sits atop each kidney. The adrenal glands produce hormones that your body needs to function properly. If you develop cancer of the adrenal glands, surgery is often used to treat it.
Surgery to remove adrenal glands is called adrenalectomy. It may also be performed if you have kidney cancer and an adrenal gland needs to be removed along with a kidney. If the cancer has spread, your surgeon also may remove nearby lymph nodes and other tissue.
An adrenalectomy may be performed in one of two ways.
Open surgery: This surgery requires the surgeon to make a large surgical incision to remove the adrenal gland. Open surgery may be recommended if your tumor is large when it’s discovered. Usually, you’re in the hospital for a few days after open surgery.
Minimally invasive surgery: Considered the gold standard for adrenal tumors, this surgery is done through a series of small cuts through the abdomen or from the back. The surgeon uses tiny instruments and a video camera inserted through these small cuts to guide removal of the adrenal gland. This is known as laparoscopic surgery. Some surgeons employ the use of a surgical robot to guide them. This is known as robotic surgery.
You may be able to go home the day after a minimally invasive surgery.
Your care team may not be able to perform a minimally invasive surgery if:
You and your doctor will determine which surgery is most appropriate for you.
Once the adrenal gland is removed, it’s sent to a laboratory where a pathologist examines it under a microscope.
Surgery to remove the adrenal glands is often recommended as a treatment for those with:
Stage 1-3 adrenocortical carcinoma: The adrenal gland is removed, and nearby lymph nodes may be removed if they’re larger than normal.
Stage 4 adrenocortical carcinoma: You may have surgery to remove cancer that has spread near the adrenal cortex. Most tumors develop in the outer part of the gland known as the cortex. The surgery in this case is palliative therapy, and it’s meant to relieve symptoms and improve quality of life.
Your care team also may recommend surgery if the adrenal cancer has recurred.
Other reasons for an adrenalectomy include:
Before your surgery, be sure that you:
If you have a tumor known as a pheochromocytoma, and it’s causing high levels of the catecholamine hormone, your doctor may request that you drink lots of liquids and eat a high-sodium diet for a week before surgery.
If you’re having open or laparoscopic surgery, you will be given general anesthesia. The surgeon makes an incision through the front of your abdomen to better see where your tumor is, how big it is, and whether it’s spread.
If your tumor is small, your surgeon may opt to make the incision in your back and approach the gland from just below your ribs.
If you’re having laparoscopic surgery, the incisions will be small. Your surgeon inserts a small narrow tube through the incisions as well as a camera. After separating your adrenal gland from your kidney, the surgeon will place it in a small bag that’s removed from your body.
Your surgeon will also determine whether nearby lymph nodes and other tissue need to be removed. They’re likely to be removed if they appear to be larger than normal.
Finally, your incisions are closed.
Some patients have adrenal cancer that has grown into their inferior vena cava, the vein that carries blood from the lower half to the heart. It may be difficult to remove the tumor in its entirety and not damage the vein, so the patient may need to be put on may need a heart-lung bypass machine while the surgeon is removing the tumor from this vein.
Possible complications of adrenal gland removal include:
Call your care team if you experience any of these signs of an infection:
Also, call your care team if:
Expect some pain after surgery. The incision area may be sore for one to two weeks.
Medications: You may relieve your pain with over-the-counter medications such as Tylenol® (acetaminophen) or Advil® (ibuprofen). You may need a small amount of narcotic pain medicine for a few days. Ask your care team about getting a prescription.
Ice: Icing your incision may reduce swelling and help relieve pain.
Rest: You may feel fine, but you need to give your body time to heal. You may do light activities once you’re home. Don’t lift objects heavier than a gallon of milk. You should be able to resume your normal activities about a week after surgery. Ask your doctor when you may resume driving.
Hormone replacement: Check with your doctor regarding any hormones that your adrenal gland made that should be replaced. Some people may need medication to replace the hormone aldosterone, as well as blood pressure medications.
Use a pillow: Keep a pillow handy to use when you cough, sneeze or take deep breaths. Place it over your incision to give you support.
Start back slowly: Moving around, once your doctor says it’s OK, is also important. Walking is a good activity to start with.
Eat normally: You likely won’t need to eat a special diet once you’re home. However, if you have an upset stomach as a result, keep your meals bland with foods such as plain rice, toast, yogurt and broiled chicken. If you’re constipated, be sure to drink lots of water and eat more fiber. Ask your care team if you need to take a stool softener or mild laxative.
Check your potassium: If your tumor made the hormone aldosterone, your doctor may ask you to have your potassium levels checked to determine whether you need blood pressure medication.
If you have stage 1 or stage 2 adrenal cancer and your entire gland was removed during surgery, you may need no further treatment. However, if your tumor wasn’t completely removed, you may also need radiation or chemotherapy.
If you have stage 3 cancer and your entire adrenal gland was removed as well as some surrounding tissue (perhaps part or all of your nearby kidney and part of your liver, and lymph nodes), you may need additional treatment such as radiation and chemotherapy.
If you have stage 4 cancer, it isn’t likely your surgeon was able to remove all of the cancer that has spread elsewhere. Your care team may recommend follow-up radiation and chemotherapy. Follow-up treatments may begin right away, or not until you’re having symptoms.