Abstract

Primary malignancy of the adrenal is probably not as rare as is commonly supposed, and a review of the literature shows reports of occasional cases. Geschickter has recently classified the types of suprarenal tumors and makes a plea for reports of these unusual cases, in order that interest in them may be stimulated and some of the confusion which now exists may be cleared up. A case which recently came under our observation in the Department of Roentgenology and later for autopsy in the Department of Pathology is, we believe, worthy of report. Case Report<sup>1</sup> Miss P. D., aged forty, was first seen in the x-ray department Dee. 24, 1933. She had come to the hospital as an out-patient and requested an x-ray examination of the chest because of a persistent cough. Films made at that time (Fig. 1) show numerous large dense areas, varying in size but of uniform density, in both lung fields but predominantly in the bases. These shadows were interpreted as areas of metastasis, unclassified, and roentgen therapy was given: 200 kv.; 0.5 mm. copper filtration; 575 <i>r</i> (measured in air) per field, anterior and posterior ports of entry over both lungs. This dosage was repeated one week later. Subsequent films, after a lapse of time, failed to show any appreciable changes in the shadows. The metastatic areas were considered resistant to further radiation and the patient was not seen again until April 1934, when films of the chest showed a large collection of fluid in both pleural cavities. Death occurred July 20, 1934, and an autopsy was performed that day.

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