Hormonal-active tumors of the adrenal cortex

The hormone-producing tumors of the adrenal cortex are one of the topical problems of modern endocrinology. Pathogenesis and clinical picture are due to the hyperproduction of certain steroid hormones by tumor tissue. Thus, with excessive allocation of glucocorticoids, the Itenko-Cushing syndrome develops , the development of the mineralocorticoid tumor underlies the primary aldosteronism. Often there is a picture of mixed hypercorticism, when the neoplasm produces several hormones, different in their biological effect on the body.

In our country, the questions of the clinic and surgery of hormone-producing tumors of the adrenal cortex are associated with the name of O. Nikolaev. The first operation of removing the hormonal-active tumor of the adrenal cortex was performed by him in 1946 for a girl of 13 years.

Given the variety of the clinical picture, a large number of classifications of tumors have been proposed in which the authors attempted to combine clinical and morphological features. In our country, most doctors use the classification of prof. O. Nikolaev, recommended by him in 1947, and later somewhat modified and supplemented.

[1], [2], [3], [4], [5]

Classification of hormonal-active tumors of the adrenal cortex

1. Aldosteroma - a tumor that produces aldosterone, causes primary aldosteronism.
2. Glucosteroma - mainly isolates glucocorticoids, is clinically manifested by the Itenko-Cushing syndrome.
3. Androsteroma - secretes mainly androgens (male sex hormones); leads to the development of virilization in women.
4. Corticoestroma - secretes estrogens (female sex hormones); causes gynecomastia and virilization in men.
5. Mixed tumors - glucoandrosteromas and others.

The name of the latter is associated with clinical manifestations. So, for example, glucoandrosteroma produces glucocorticoids and androgens and is characterized by clinical signs of the syndromes of Itenko-Cushing and the viral.

The above classification is simple and convenient, since in each specific case it gives an idea of the type of hypercorticism. Although it should be noted that absolutely "clean" its species in practice are infrequent.

In addition to this classification, all neoplasms of the adrenal glands (bark) are divided into benign (adenomas) and malignant (carcinomas). This division is also important, as the rapid removal of adenoma is accompanied by almost complete recovery.

[6]