Is Blood in Urine (Hematuria) a Symptom of Adrenal Cancer?

Blood in the urine (hematuria) is not a typical symptom of adrenal cancer. Adrenal tumors usually cause signs related to excess hormone production (like high blood pressure, weight changes, or muscle weakness) or symptoms from a large mass pressing on nearby organs, rather than urinary bleeding. ^{[1] [2]}

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What Adrenal Cancer Usually Looks Like

• Hormone-related symptoms: Depending on the hormones produced, people may notice weight gain, easy bruising, high blood pressure, diabetes, mood changes, fatigue, muscle weakness, or changes in hair growth and menstrual cycles. These reflect adrenal cortex overproduction (cortisol, androgens, aldosterone) and are more typical than urinary symptoms. ^{[1] [2]}

• Mass effect symptoms: Large adrenal tumors can cause abdominal or back discomfort, a feeling of fullness, or symptoms from pressing on nearby structures; these are non‑specific and still do not commonly include hematuria. ^{[1] [2]}

• Rarity: Adrenal cortical carcinoma is rare, and most adrenal growths are benign or found incidentally; this rarity further means its symptom profile is well described and generally does not include blood in urine. ^{[3] [1]}

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When Hematuria Could Appear

While hematuria is uncommon in adrenal cancer, it can occur in special circumstances:

• Concurrent kidney involvement: A large adrenal mass can extend into or compress the kidney or renal vasculature; in rare cases, this could contribute to urinary bleeding, though it is not a classic presentation. Case literature more commonly links hematuria to primary kidney cancers rather than adrenal tumors. ^[4]

• Synchronous tumors: Very rare reports describe a person having both adrenal cortical carcinoma and a separate kidney cancer; in such a scenario, the hematuria would more likely be from the kidney cancer. ^{[5] [6]}

• Retroperitoneal hemorrhage: Adrenal tumors (or metastases to adrenal) can bleed internally into the retroperitoneum, causing pain and shock in severe cases, but this bleeding is typically outside the urinary tract, so it does not present as hematuria. ^{[7] [8]}

Overall, hematuria points more strongly to urinary tract causes such as kidney stones, infections, kidney or bladder tumors, or prostate issues, rather than adrenal pathology. ^[1]

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Common Symptoms of Adrenal Tumors (Quick Reference)

• High blood pressure and increased thirst or urination (from hormonal effects). ^{[9] [10]}
• Unexplained weight gain, weakness, and skin changes with cortisol excess (Cushing’s features). ^{[11] [2]}
• Excess hair growth or menstrual irregularities from androgen excess. ^[2]
• Rarely, aldosterone excess causing high blood pressure and low potassium. ^[12]

These patterns are more consistent with adrenal disease than hematuria. ^{[1] [2]}

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What To Do If You Have Blood in Your Urine

• Seek prompt evaluation: Hematuria deserves medical assessment because it can signal infection, stones, or urinary tract cancers, which need timely care. A clinician may recommend urine tests, imaging of the kidneys and bladder, and possibly cystoscopy to identify the source. While adrenal cancer is unlikely to be the cause, imaging can also incidentally reveal adrenal masses if present. ^[1]

• Consider risk factors and associated symptoms: If hematuria accompanies flank pain, fever, urinary urgency, or weight loss, these details help guide the work‑up toward more common urinary tract causes rather than adrenal disease. ^[1]

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Key Takeaways

• Hematuria is not a typical symptom of adrenal cancer. Adrenal tumors usually present with hormone-related changes or mass effect symptoms. ^{[1] [2]}

• Rare exceptions exist, such as synchronous kidney tumors or extensive local invasion, but these are uncommon and hematuria would more often point to kidney/bladder conditions. ^{[5] [4]}

• Medical evaluation for hematuria is important to determine the true cause and ensure appropriate treatment. ^[1]