adrenal gland abnormality

[myntie]

I went to the doctor complaining of excessive facial hair which has gradually gotten worse over the last couple of years. I also haven't been able to get pregnant over the last 3 years, and have been to the doctor several times for abdominal pains on my right side that make walking unbearable, but they do an xray and say it's ntohing. Once or twice I was told that I had a uterine cyst that burst, but otherwise they told me it was normal.

I went to the doctor more recently because the hair has been getting worse, even on my breasts and chest and my pubic hair grows really fast, so much that I have to wax/shave every other or every 2 days.

She did several tests and found I had elevated DHEAS levels near the 600s but normal testosterone, though my 17-0H progesterone was low (10) as well as FSH levels (which were at 3 a week before my period was due (which is irregular alternating between 30-35 day cycles) and LH which was at 15. I went for a CT scan and he said my adrenal gland was abnormal.

My question is, does an abnormality necessarily mean a tumor, or can it just mean it's larger than normal or something else?

Also, if it is a tumor, and it is functioning, does that mean cancer? Or does it just mean a functioning tumor? What is the difference. I am scheduled for an MRI.

I was looking at Cushings, but it doesn't seem like me, because my cortisol was normal (even towards the low end) and I don't have acne, a hump, or moon face, and my blood pressure is excellent, actually a bit low -- though I've always gained weight in my abdomen before everywhere else, and I'm naturally muscular and athletic.

I have been hypoglycemic at times. I also have been told my white blood cell count is high and I am somewhat anemic. I don't know what's wrong, but could all of these things be related to the adrenal gland?

[Fernando Roque, MD]

Hi.  You can search medical websites such as www.emedicine.com or medscape.com for information regarding pituitary or adrenal adenomas.  As for your fertility issues, I think you need to be worked up further to determine what's causing the infertility.  From the information you've given, there isn't enough evidence to definitely point to an adenoma as the primary cause of your infertility.   The status of your ovaries and other parts of your reproductive tract have to be examined as well.  Your doctor also has to check if the infertility is part of a larger endocrine syndrome.

[janeofjungle]

Hi. I have a question...are you still on this website?

[myntie]

Thank you Dr. Roque, that clears up a lot for me. My doctor didn't specify what kind of abnormality, but I will ask her to clarify.

I was scared that if it's found to be a tumor that would mean automatically that I have cancer, but thank you for clearing that up.

I will also ask about checking the pituitary gland.

Do you know of any resources for info. on adenomas interfering with fertility? Could all of my fertility issues be caused by just the adenoma, or usually is it in conjunction with a uterine issue as well?

thanks again

[Fernando Roque, MD]

Hi.  What exactly was the abnormality of the adrenal gland noted on CT scan? Enlargement of the gland?  If your adrenal gland is enlarged, it may mean that a tumor is present (an adrenal adenoma - a benign tumor) or if both adrenals are diffusely enlarged, there may be something wrong with the pituitary gland - usually a pituitary adenoma, which produces hormones stimulating the enlargement of the adrenals.

Adenomas, whether adrenal or pituitary, are typically non-cancerous tumors.  "Functioning" tumors mean that those tumors are capable of producing the hormones normally made by the gland.  In the case of adrenal adenomas, either cortisol, aldosterone (a hormone controlling salt metabolism) or androgens (male sex hormones) may be produced in excess.  Cancer implies an abnormality in which cells have uncontrolled growth and multiplication, and gain the ability to metastasize to other body sites.  Adenomas represent an abnormal growth of the gland, but these are not cancerous since they have not gained the ability to metastasize.

From what you have described, my guess is that you may have either a pituitary or an adrenal adenoma which are producing hormones other than cortisol.  You may need to have a cranial CT done as well to check for any pituitary lesions.