CHAPTER VII. 



ADRENAL TUMORS AND DYSTROPHIES OF 

 ADRENAL ORIGIN. 



There are two varieties of adrenal tumors. 



1. Benign tumors, which are only discovered acciden- 

 tally at autopsy and have no clinical history. Fibromata, 

 hydatid cysts are exceptional, adenomata more frequent. 

 They are found in individuals having died from numerous 

 causes (pneumonia, nephritis, tuberculosis, atheroma, etc.). 



2. MALIGNANT TUMORS. Some are secondary to a 

 carcinoma in the neighborhood (kidney, pancreas, stom- 

 ach) and are without clinical interest; the others are 

 primary and develop from the adrenal tissues. 



From an anatomical point of view these primary malig- 

 nant tumors are carcinomata, which nearly always develop 

 in the cortex, or sarcomata which are rather large in size 

 and filled with blood. These are most commonly found 

 in the young. 



From a clinical point of view, these tumors are some- 

 times latent and only discovered at autopsy. In other 

 cases, they constitute abdominal or lumbar abdominal 

 tumors, the clinical diagnosis of which is very difficult. 

 They are rounded, tabulated, irregular and of a hard 

 consistency, adherent and sometimes as large as an infant's 

 head. They have a lumbar pedicle and are as movable as 

 renal tumors. In other cases they are absolutely immov- 

 able and do i not rise on inspiration. Sometimes they are 

 associated with ascites and with a collateral abdominal 

 circulation, edema of the lower extremities and of the 

 region below the umbilicus, when the inferior vena cava 

 is compressed. 



11 161 



