Hormonally active tumors of the adrenal cortex

Hormone-producing tumors of the adrenal cortex are one of the pressing problems of modern endocrinology. Pathogenesis and clinical picture are caused by hyperproduction of certain steroid hormones by tumor tissue. Thus, with excessive secretion of glucocorticoids, Itsenko-Cushing syndrome develops, the production of mineralocorticoids by the tumor is the basis of primary aldosteronism. Often, a picture of mixed hypercorticism is observed, when the neoplasm produces several hormones that differ in their biological effect on the body.

In our country, the issues of clinical and surgical treatment of hormone-producing tumors of the adrenal cortex are associated with the name of O. V. Nikolaev. He performed the first operation to remove a hormone-active tumor of the adrenal cortex in 1946 on a 13-year-old girl.

Considering the diversity of the clinical picture, a large number of tumor classifications have been proposed, in which the authors attempted to combine clinical and morphological signs. In our country, most doctors use the classification of Professor O. V. Nikolaev, recommended by him in 1947, and later somewhat modified and supplemented.

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Classification of hormonally active tumors of the adrenal cortex

1. Aldosteronoma is a tumor that produces aldosterone, causing primary aldosteronism.
2. Glucosteroma - secretes mainly glucocorticoids, clinically manifested by Itsenko-Cushing syndrome.
3. Androsteroma - secretes predominantly 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 - glucandrosteromas and others.

The name of the latter is associated with clinical manifestations. For example, glucandrosteroma produces glucocorticoids and androgens and is characterized by clinical signs of Itsenko-Cushing and virilization syndromes.

The given classification is simple and convenient, as in each specific case it gives an idea of the type of hypercorticism. Although it should be noted that absolutely "pure" types of it are rarely encountered in practice.

In addition to the above classification, all neoplasms of the adrenal glands (cortex) are divided into benign (adenomas) and malignant (carcinomas). This division is also important, since surgical removal of an adenoma is accompanied by almost complete recovery.

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