The surgical treatment of Cushing's syndrome and other adrenal cortical abnormalities.

Classification of Adrenal Cortical Disorders Lesions of the adrenals frequently cause disturbance of endocrine function. Various clinical syndromes may result, depending on whether the secretion is increased or diminished and, when it is increased, which hormones predominate. The lesions and syndromes may be classified as follows: A. WITH DISTURBANCE OF CORTICAL FUNCTION i. Increased Secretion: Lesions: (i) Hyperplasia. (ii) Adenoma. (iii) Carcinoma. Syndromes: Excess ofGlucocorticoids causes Cushing's syndrome. Androgens causes virilism (adreno-genital syndrome and some features of Cushing's syndrome). Oestrogens causes feminization. Electrocorticoids causes hyperaldosteronism (Conn's syndrome). 2. Decreased Secretion: Lesions: (i) Atrophy. (ii) Destruction by haemorrhage, infarct, tuberculosis, metastatic carcinoma, etc. (iii) Surgical removal. Syndromes: Chronic deficiency causes Addison's disease. Acute deficiency causes acute adrenal failure (adrenal crisis). B. WITHOUT DISTURBANCE OF FUNCTION Lesions: (i) Adenoma. (ii) Carcinoma. (iii) Rare tumours, cysts, etc.