Glucosteroma is a hormone-active tumor of the adrenal cortex, originating mainly from its bundle zone, excessively excreting corticosteroids, mainly glucocorticoids, and characterized by a clinical picture similar to Itsenko-Cushing’s disease. Glyukosteroma most often occurs in women, especially between the ages of 18 and 42 years.
Historical data. The syndrome of glucocorticoid hypercortisolism was first described by Cushing in 1912.
Etiology. The cause of the disease is unknown.
Pathogenesis. The pathogenesis of glucose steromas is similar to the pathogenesis of Itsenko – Cushing disease and is due to increased production of mainly glucocorticoids.
Pathological anatomy. A pathoanatomical study reveals a tumor of the adrenal cortex, often malignant, rarely benign. The mass of the tumor varies from 5 g to 5 kg. In the tumor are usually found areas of hemorrhage and no drops. Histologically, in the adenoma, mainly cells of the beam zone are found (compact cells with oval nuclei located in the form of cords). In a malignant tumor, rapid metastasis occurs in another adrenal gland, liver, lungs, brain and bones. Opposite adrenal gland
as a rule, hypotrophied. The morphological changes of other organs and systems are basically the same as in the case of Itsenko – Cushing disease.
Clinic. The glucose steromy clinic is in many ways similar to Cushing’s Itsenko disease. In contrast to the latter, the course of the disease with glucose meter, especially malignant, is more rapid, with more pronounced virilism (hirsutism, hypertrichosis, etc.).
to Radioisotope diagnosis of the adrenal – ° c. Radiodiagnosis. On a scintiphotograph and X-ray gram, there is a one-sided adrenal tumor with
simultaneous hypoplasia of another adrenal gland. Diagnostic tests – see. “Itsenko disease –
Cushing.
Diagnosis and differential diagnosis. The diagnosis of the disease is established on the basis of a characteristic clinical picture of diagnostic samples, but mainly on the data of radioisotope diagnostics and X-ray diagnostics (photo scintigraphy, pneumosuprenography, adrenal angiography). Differential diagnosis of the disease – see “Itsenko – Ku ~ Shing Disease”.
Forecast. With early Diagnosis and timely operative treatment of benign, and in some cases malignant adrenal adenoma, the prognosis is favorable, with adenocarcinoma in the presence of metastases – unfavorable. Without operative treatment, patients die from cerebral hemorrhage, cardiac decompensation, sepsis, pneumonia, renal failure, tumor metastases affecting vital organs (liver, lungs).
Treatment. Treatment only operative – removal of the tumor. In connection with the hypotrophy of the opposite adrenal gland, corticosteroid replacement therapy is prescribed in the postoperative period. In inoperable forms of cancer of the adrenal cortex, drugs blocking the synthesis of corticosteroids (chloditan, elipten, etc.) can be used.