Based on PubMed | Can adrenal cancer cause difficulty swallowing?

Adrenal cancer and difficulty swallowing: what’s the link?

Difficulty swallowing (dysphagia) is not a typical symptom of adrenal cancer itself, but there are a few indirect ways adrenal tumors could be associated with swallowing problems. Most people with adrenal cancer present with abdominal or back pain, weight changes, or hormone-related symptoms rather than throat or esophageal complaints. ^{[1] [2]}

Typical adrenal cancer symptoms

Adrenal cancer usually causes symptoms from hormone overproduction (like features of Cushing’s syndrome or virilization) or from a large mass in the abdomen. Common signs include back pain, belly pain, unintended weight loss, and loss of appetite. ^{[1] [2]} When tumors grow large, they can press on nearby abdominal organs, leading to a feeling of fullness, abdominal discomfort, and weight loss. These pressure effects occur in the abdomen and retroperitoneum rather than the neck or throat. ^{[3] [4]}

Can adrenal tumors directly cause dysphagia?

Direct obstruction or compression of the esophagus by an adrenal tumor would be highly unusual because the adrenal glands sit deep in the upper abdomen atop the kidneys, far from the esophagus in the chest and neck. Large adrenal masses can invade local structures or extend into major veins (like the inferior vena cava), but reports focus on abdominal symptoms and vascular involvement rather than esophageal compression. ^{[5] [6]} In practice, dysphagia due to purely local mass effect from an adrenal carcinoma would be exceedingly rare and not expected.

Indirect mechanisms that could be related

While adrenal cancer itself does not commonly cause swallowing difficulty, two indirect scenarios may connect cancer and dysphagia:

• Metastatic disease: Adrenal cortical carcinoma can spread to the lungs, liver, peritoneum, lymph nodes, and bones. If metastatic disease involves structures near the esophagus or causes systemic effects leading to weight loss and weakness, some people may experience trouble swallowing, but this is not a recognized hallmark of adrenal cancer. ^[7]
• Paraneoplastic and treatment-related causes: Across cancers in general, dysphagia can arise from nervous system involvement, treatment side effects (surgery, chemotherapy, radiation), or secondary esophageal motility problems. Cancer-associated swallowing issues are well documented broadly, but they are typically linked to head and neck, esophageal, or thoracic malignancies rather than adrenal tumors. ^{[8] [9]}

What to consider clinically

If someone with a known or suspected adrenal mass has difficulty swallowing, clinicians generally look for other, more likely causes:

• Esophageal conditions (strictures, reflux esophagitis, eosinophilic esophagitis, or primary motility disorders such as achalasia). Esophageal dysphagia is most often due to local neuromuscular disorders or obstructive lesions of the esophagus itself. ^[9]
• Cancers closer to the esophagus (head and neck or thoracic tumors) that can directly affect swallowing. Swallowing dysfunction is a recognized complication in many cancers, particularly those treated in the head and neck region. ^[8]

Bottom line

• Adrenal cancer does not typically cause difficulty swallowing, and dysphagia is not listed among its common symptoms. ^{[1] [2]}
• Large adrenal tumors may cause abdominal pressure symptoms but not throat/esophageal compression, given their anatomical location. ^{[3] [4]}
• If dysphagia is present, it’s more likely due to esophageal disease, another tumor closer to the swallowing pathway, metastatic involvement outside the adrenal region, or general cancer/treatment-related effects, rather than the adrenal tumor itself. ^{[8] [9]}