PARTIAL HORMONAL DEPENDENCY OF BILATERAL MALIGNANT ADRENOCORTICAL NODULAR HYPERPLASIA

  • 1 January 1978
    • journal article
    • research article
    • Vol. 39  (1) , 1-14
Abstract
Bilateral malignant polyadenomas of [human] adrenals seem to be rare. They involve either a double primary adrenal tumor, or a metastasis of a contralateral tumor. The evolution in this case was characterized by periods of central stimulation with partial autonomy, and periods of tumoral autonomy with central inertness. Pathological findings consisted of coexistence of various histological aspects (atrophy, hyperplasia, benign adenoma, carcinoma) suggesting the successive steps of particular adrenal carcinogenesis. Stimulation by ACTH might have resulted initially in a preneoplastic hyperplasia, then in an incompletely autonomous tumor and finally in an autonomous tumor. Accordingly, from a practical and therapeutic point of view, it would be suitable, after removal of an adrenal tumor, especially of one with demonstrated ACTH-dependence, to totally suppress endogenous ACTH by cortisol or cortisone therapy to reduce the occurrence of corticotropin stimulation of possible remaining malignant adrenal cells.

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