[Surgical treatment of functional tumors of the adrenal gland]

Abstract

The authors evaluated and operated 40 cases of Cushing's syndrome, 8 cases of Conn's syndrome and 19 cases of phaeochromocytoma. The diagnosis was frequently delayed due to inadequate hormonal analysis. Cancer of the adrenal gland was observed in 17% of cases of Cushing's syndrome, while all cases of Conn's syndrome corresponded to an adenoma. There was a female predominance for both Cushing's syndrome and Conn's syndrome. Four malignant lesions were observed in the series of 19 tumours of the adrenal medulla (21% of cases). CT scan was found to be the most accurate of modern diagnostic techniques and was able to define the site and the dimensions of the adrenal tumour. Arteriography was particularly useful in cases with large, highly vascular tumours. The preferred surgical approach was lumbotomy, less frequently laparotomy, and, in cases of invasive tumour, thoraco-phreno-laparotomy. Removal of the tumour by adrenalectomy led to resolution of the symptoms and, in benign cases, complete cure.