TUMORS 335 



Although the blood pressure in many cases of chromaffinoma 

 is normal, a group of patients have been described in whom 

 this tumor was associated with hypertension, hypertrophy of 

 the left ventricle, albuminuria, and spasm of the retinal arteries 

 which have lead to the erroneous diagnosis of contracted kidney. 

 At autopsy, however, the renal damage was found to be mini- 

 mal. As typical of the clinical picture observed in these pa- 

 tients, a case of a chromaphil tumor of ZuckerkandPs body 

 described by Reichardt 517 may be cited. The patient, a 53 

 year old woman, complained of headache and fatigue with 

 some loss of vision. There was marked pallor, a tendency to 

 sweating, spastic retinitis, dilated pupils, and albuminuria. 

 The blood pressure ranged from 200/115 to 230/140. There 

 was no edema or signs of circulatory insufficiency, and the 

 renal function tests gave normal results. The patient was 

 bled and digitalized but died suddenly on the ninth day of her 

 stay in the hospital. At autopsy a greyish red tumor, the 

 size of an apple, occupied the site of ZuckerkandPs body. The 

 kidneys and circulatory system were found to be entirely 

 normal. 



Belt and Powell 51 have suggested the term "adrenal sym- 

 pathetic syndrome" to denote the clinical condition associated 

 with chromaphil cell tumors. The outstanding symptoms of 

 this syndrome are evidences of instability of the sympathetic 

 nervous system, hypertension or paroxysmal hypertension, 

 glycosuria, periodic attacks of tachycardia, vasoconstriction 

 and vasodilation of the peripheral vessels (as evidenced by 

 pallor followed by flushing), headaches, nausea, vomiting, 

 sensations of constriction in the epigastrium with dyspnoea, 

 and a susceptibility to shock. Operative removal of the 

 chromaffinomas has proven curative in a number of cases re- 

 ported in the literature. 446, 566 



TUMORS OF THE CORTEX 



The tumors of the adrenal cortex may be divided into those 

 which originate from the interrenal tissue and those whose 



