Hyperplastic and Tumorous Lesions of the Adrenals in an Unselected Autopsy Series

In an unselected consecutive postmortem series, 512% of the adrenals showed cortical nodules with diameters up to 1 mm in 13%, between 1 and 2 mm in 28% and < 2 mm in 12%. In 22% of cases only one nodule was present; whereas in 15% two nodules and in 17% more than three nodules were found. A cortical adenoma was detected in 5% of cases. Adenomas were smaller than 6 mm in 1% and < 15 mm also in 1% of the entire collection. For differentiation of nodules criteria listed in Table 4 were used. Correlation with clinical data revealed a significantly higher number of nodules and an adenoma more frequently in hypertensive patients. Metastases were found in 19% of all cases with malignant tumors. Twenty-three percent of the metastases were smaller than 1 mm and 20% were < 10 mm in diameter. Adrenal metastases usually indicated generalized dissemination of the tumor.