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What does adrenal nodule in a person with history of carcinoid syndrome indicate?

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Posted on Wed, 27 May 2015
Question: I was diagnosed with carcinoid syndrome after a bowel resection. There were stones in the small intestine which had been blocking them for 6 yrs. and with gastro testing went undetected. It caused the wall to be pushed out and 3 lymph-nodes became malignant. That section was removed. I also was diagnosed 6 yrs. prior with a non functional adrenal gland with a node sitting on top of it. I have never been treated for that. I have received sandostatin injections since Sept. of 2014. Now the thyroid is hypo at 8.36 range. My question is: Do you believe that the adrenal gland not being monitored is the main reason for all of thee above? I was taking 15 mg. once a day of Armour and I became so lifeless and dizzy/nausea that I could not function. Blood work had not been done for the thyroid since Dec. I stopped taking Armour and feel 80% better. I just need to know what direction I need to stay on top of this. Thank you! XXXXXXX
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Answered by Dr. Binu Parameswaran Pillai (50 minutes later)
Brief Answer:
Need further evaluation

Detailed Answer:
Good day,
Noted your concern.
With the history of carcinoid syndrome with lymph node metastasis, in the background, I would certainly be concerned about the adrenal nodule. How big is this? You will need to do few tests ( CT scan, serum cortisol test, 24 hour urine free cortisol, Plasma Metanephrines and nor metanephrines etc). If these are normal and if CT shows benign characters and if nodule is less than 4 cm in size, not to worry.

There is a possibility that your adrenal gland is not functioning well. In that case, you need adrenal steroid replacement prior to taking Thyroid medications. Otherwise, you will feel tired. Discuss with your Endocrinologist on your next visit.




Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Binu Parameswaran Pillai

Endocrinologist

Practicing since :2003

Answered : 1435 Questions

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What does adrenal nodule in a person with history of carcinoid syndrome indicate?

Brief Answer: Need further evaluation Detailed Answer: Good day, Noted your concern. With the history of carcinoid syndrome with lymph node metastasis, in the background, I would certainly be concerned about the adrenal nodule. How big is this? You will need to do few tests ( CT scan, serum cortisol test, 24 hour urine free cortisol, Plasma Metanephrines and nor metanephrines etc). If these are normal and if CT shows benign characters and if nodule is less than 4 cm in size, not to worry. There is a possibility that your adrenal gland is not functioning well. In that case, you need adrenal steroid replacement prior to taking Thyroid medications. Otherwise, you will feel tired. Discuss with your Endocrinologist on your next visit.