Neoplastic Disorders of the Adrenal Glands

Tumors of the adrenal glands cause a variety of endocrine disturbances including not only Cushing's and the adrenogenital syndromes but also hypertension. The ready availability of novel imaging techniques has resulted in an increased recognition of hitherto unsuspected adrenal lesions. Most are small and without overt function but a significant number of pheochromocytomas are found in this manner. Several familial syndromes have been found to be the basis for the development of pheochromocytomas and paragangliomas. The etiology of adrenocortical tumors remains unknown, although the molecular changes associated with progression and malignancy have become better appreciated. The distinction of benign from malignant tumors relies principally on histology and remains difficult in many instances. Surgery is the only method of cure; chemotherapy is unhelpful such that the outlook for patients with advanced carcinomas is poor.