Hyperplasia and Tumors of the Adrenal Cortex

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Abstract
An outline of the important historical events relative to surgery of the adrenals since Thomas Addison’s brilliant description in 1855 will be brought up-to-date. The pathologic physiology of hyperadrenocorticism due to both hyperplasia and neoplasm of the adrenal cortex will be described. Biochemical abnormalities of each type of pathology will be summarized. The changes in inorganic metabolism, organic metabolism, cellular effects and sexual effects will be outlined in detail. Various methods of laboratory valuation of the adrenal cortical function will be described. Biochemical techniques for differentiation of the various hyperfunctioning states of the adrenal cortex from both hyperplasia and tumor are described in detail. The diagnosis and treatment of hyperadrenocorticism due to hyperplasia is considered and followed by a similar discussion of neoplasms both malignant and benign of the adrenal cortex causing hyperadrenocorticism. The syndromes of hyperaldosteronism, the adrenogenital syndrome and the feminizing adrenogenital syndrome in male are each discussed in detail. The experience of the Peter Bent Brigham Hospital urologic service during the last twenty years in collaboration with the metabolic service of Dr. GEORGE W. THORN is summarized with reference to the management of hyperadrenocorticism. During this period, there were 63 patients operated upon for hyperadrenocorticism due to adrenocortical hyperplasia, 74 patients were explored for adrenal tumors both cortex and medulla. Currently there have been 23 patients having pheochromocytoma from whom a total of 28 tumors have been removed. This latter series will be reported elsewhere.

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