Pheochromocytoma and Adrenal Cortical Adenoma. Report of a Case with both Tumors and Discussion of their Relation.

摘要

The independent investigations of Vogt (1, 2) and Long (3, 4) from 1944 to 1947 firmly established in laboratory animals a secretory relationship between the adrenal medulla and cortex. Epinephrine released by splanchnic stimulation or injected intravenously is followed by increased cortical secretion. This action of cpinephrine has been demonstrated by Long to take place via the anterior pituitary. The epinephrine stimulates the anterior pituitary to release corticotropic hormone (ACTH) which, in turn, stimulates the adrenal cortex. Clinical confirmation of these laboratory studies has been obtained by Thorn et al. (5), who have demonstrated that epinephrine causes a depression in circulating eosinophils comparable to that following administration of ACTH (6). In view of this physiologic relationship between the medulla and cortex of the adrenal gland, now apparently well established, it is curious that patients with a hypersecreting tumor of the adrenal medulla, i.e., a pheochromocytoma, do not commonly exhibit obvious disturbance of adrenal cortical function.