Are Night Sweats a Symptom of Adrenal Cancer?

Night sweats are not a typical or defining symptom of adrenal cancer (adrenocortical carcinoma). Most adrenal cancers present with signs of excess hormone production (especially cortisol causing Cushing syndrome) or with nonspecific abdominal symptoms; night sweats are not listed among the core features. ^{[1] [2]} In contrast, sweating (including excessive perspiration that may feel like night sweats) is a classic symptom of a different adrenal tumor called pheochromocytoma, which causes bursts of adrenaline-like hormones. ^{[3] [4]}

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What adrenal cancer usually looks like

Adrenal cancer is rare and often either produces excess hormones or grows large enough to cause pressure symptoms. The most common hormonal pattern is excess cortisol (Cushing syndrome). ^{[1] [2]} Typical features include:

• Weight gain, especially abdominal and face rounding. ^{[1] [2]}
• Muscle weakness and pink/purple stretch marks. ^[1]
• Easy bruising, high blood pressure, and high blood sugar. ^{[1] [2]}

Less commonly, adrenal cancer can produce sex hormones (estrogen or testosterone), causing changes like hair loss on the head or extra facial/body hair and menstrual irregularity in women, or breast enlargement and testicular shrinking in men. ^[5] It can also rarely produce aldosterone, leading to high blood pressure and low potassium. ^[5]

Most adrenal gland tumors are actually benign and often discovered incidentally; malignant adrenal cancers are uncommon. ^[6] When adrenal cancer spreads, symptoms may broaden, but night sweats are not a hallmark feature. ^[7]

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When sweating does point to an adrenal tumor

Sweating sometimes severe is a hallmark of pheochromocytoma, a catecholamine‑producing tumor of the adrenal medulla. People with pheochromocytoma often have episodes of headaches, pounding heart, anxiety, and sweating. ^{[3] [8]} These episodes can occur day or night and may be experienced as night sweats. High blood pressure and palpitations commonly accompany the sweating. ^[8]

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Fever vs. night sweats in adrenal tumors

A minority of adrenal tumors can present with prolonged fever, which may lead to sweating at night, but this is uncommon. Reports suggest about 6–10% of adrenal tumors may initially present with fever, including nonfunctional adrenal cortical carcinomas, pheochromocytomas, or aldosterone-producing tumors. ^{[9] [10]} Fever is different from the adrenaline-driven sweating of pheochromocytoma and is not a routine feature of adrenal cancer.

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How clinicians evaluate sweating with suspected adrenal disease

Because night sweats are nonspecific, clinicians look for accompanying signs and use targeted tests:

• Signs pointing to adrenal cancer (cortisol excess): weight gain, purple stretch marks, muscle weakness, easy bruising, high blood pressure, high blood sugar. ^{[1] [2]}

  • Common first-line evaluations for Cushing syndrome include urinary free cortisol, late‑night salivary cortisol, and a 1‑mg overnight dexamethasone suppression test, followed by imaging if abnormal. ^[11]

• Signs pointing to pheochromocytoma: episodic headaches, palpitations, anxiety, and sweating (which can feel like night sweats), typically with high blood pressure. ^{[3] [8]}

  • The most sensitive screening is plasma free metanephrines or 24‑hour urinary fractionated metanephrines/catecholamines, followed by CT/MRI and specialized imaging for localization. ^{[12] [13]}

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Practical takeaways

• Night sweats alone are unlikely to be due to adrenal cancer. Adrenal cancer more often shows cortisol excess symptoms or mass‑effect abdominal symptoms, not isolated night sweating. ^{[1] [2]}
• Consider pheochromocytoma if night sweats come with episodes of pounding heart, headaches, anxiety, and high blood pressure. Sweating is a core feature of these adrenaline‑secreting tumors. ^{[3] [8]}
• Persistent fevers with night sweats are uncommon but have been reported with some adrenal tumors; this pattern should prompt a thorough evaluation to rule out infection, hematologic conditions, and malignancy. ^{[9] [10]}

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Symptom comparison table

Feature	Adrenal Cancer (Adrenocortical Carcinoma)	Pheochromocytoma
Typical hormone excess	Cortisol (Cushing syndrome)	Catecholamines (adrenaline-like)
Common symptoms	Weight gain, muscle weakness, purple stretch marks, easy bruising, high blood pressure, high blood sugar	Episodic headaches, palpitations, anxiety, sweating, high blood pressure
Night sweats	Not typical	Common as part of sweating episodes
Less common hormone excess	Sex hormones (estrogen/testosterone), aldosterone
Initial tests	Cortisol tests (urine/saliva), dexamethasone suppression, imaging	Plasma free or 24‑hr urine metanephrines/catecholamines, imaging
Rarity	Rare malignancy	Rare, mostly benign tumor

Citations: Adrenal cancer symptoms and hormone patterns. ^{[1] [2]} Pheochromocytoma symptoms and sweating. ^{[3] [8]} Cortisol testing in Cushing syndrome. ^[11]

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Bottom line

Night sweats are not a characteristic symptom of adrenal cancer; they are more suggestive of pheochromocytoma when accompanied by headaches, palpitations, anxiety, and high blood pressure. ^{[1] [2] [3]} If night sweats occur with signs of cortisol excess or persistent fevers, a medical evaluation is advisable to consider adrenal and non‑adrenal causes. ^{[1] [9]}