[Similarity and differences of the pathogenesis of Itsenko-Cushing syndrome variants]

Proceeding from a study of the results of the investigation of 152 patients with Icenko-Cushing's syndrome the authors have arrived at the conclusion that hyperplasia, clear cell adenoma of monomorphous structure, dark cell and mixed adenomas of polymorphous structure, cancer of the adrenal cortex are different stages of a common pathological process. Such formation of morphological changes in the adrenal gland is one of the ways of development of Icenko-Cushing's syndrome. To confirm the proposed concept of the pathogenesis of this disease the authors provide some evidence of hyperplasia or the normal structure of nontumorous adrenocortical tissue in adenoma and cancer, of the absence of difference in a rise of the mean ACTH level in the blood in hyperplasia and different adrenocortical tumors. An increase in ACTH production in most of the patients should be regarded as one of the primary factors of the above morphological changes. The absence of suppression of 17-oxycorticosteroid excretion with urine in a test with 8 mg of dexamethasone in most of the patients with dark cell and mixed adenoma of polymorphous structure and adrenocortical cancer suggests a possibility of the development of certain autonomy of these neoplasms.