[Pathologic anatomy of adrenal tumors]

Review of the pathology of benign and malignant tumors of the adrenal gland. Generally, all neoplasms of the adrenal gland may show endocrine activity with respective clinical syndromes. Such syndromes may give first clues for the important differential diagnosis between hyperplasia and neoplasia. There is no correlation between morphology and function of the various tumors. Cancers of the adrenal cortex are extremely rare. They occur at any age. At infancy, neoplasms of the adrenal cortex are almost always hormonally active and malignant. Adenomas and carcinomas of the adrenal cortex are discussed with special reference to the difficulty of differential diagnosis. The prognosis of carcinomas of the adrenal cortex is poor. The five years' survival rate amounts to 10--25%. The dignity of phaeochromocytoma can hardly be established by morphology alone. Most of them are benign. Metastases of these tumors are the only certain criterion of malignancy. Neuroblastoma metastasizes very early and--in case of bone marrow involvement--must be separated from lymphosarcoma, Ewing's sarcoma, and from undifferentiated leukemias. Cysts of the adrenal gland are very rare but they are important in the differential diagnosis of adrenal masses. Finally, tumors like myelolipoma are briefly discussed.