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February 1960

The Roentgen Diagnosis of Adrenal Tumor in Cushing's Syndrome

AMA Arch Intern Med. 1960;105(2):257-263. doi:10.1001/archinte.1960.00270140079009

The crucial problem in the treatment of Cushing's syndrome is the differentiation of tumor from nontumorous hyperfunction of the adrenal cortex. The usefulness of the roentgen examination in the detection of adrenocortical tumor has been noted on several occasions. Special emphasis has been laid on perirenal or presacral gas insufflation. However, most reports are concerned with the principles involved and do not include statistical documentation of the claims made.1-7

This report is concerned with an evaluation of the efficacy of the roentgenogram in making a diagnosis of the presence or absence of tumor based on 57 instances of Cushing's syndrome observed personally by the authors at The Mount Sinai Hospital. The detailed clinical manifestations of these patients are being reported in separate publications.8,9

Methods  In the patients in this series, the roentgen examination in sequential order included a flat plate, intravenous pyelography, and presacral or perirenal gas insufflation,

Joelson, J. J.; Persky, L., and Rose, F. A.:  Radiographic Diagnosis of Tumors of the Adrenal Gland ,  Radiology 62:488, 1954.Crossref
Hinman, F., Jr.; Steinbach, H. L., and Forsham, P. H.:  Preoperative Differentiation Between Hyperplasia and Tumor in Cushing's Syndrome ,  Tr. Am. A. Genito-Urin. Surgeons 48: 97, 1956.
Cope, O., and Raker, J. W.:  Cushing's Disease ,  New England J. Med. 253:119, 1955.Crossref
Plotz, C. M.; Knowlton, A. I., and Ragan, C.:  Natural History of Cushing's Syndrome ,  Am. J. Med. 13:597, 1952.Crossref
Poutasse, E. F.:  Value and Limitation of Roentgenographic Diagnosis of Adrenal Disease ,  J. Urol. 73:891, 1955.
Steinbach, H. L., and Smith, D. R.:  Extraperitoneal Pneumography in Diagnosis of Retroperitoneal Tumors ,  A.M.A. Arch. Surg. 70:161, 1955.Crossref
Montgomery, D. A. D., and Welbourn, R. B.:  Cushing's Syndrome ,  Brit. J. Surg. 45:137, 1957.Crossref
Soffer, L. J.; Iannaccone, A., and Gabrilove, J. L.:  Cushing's Syndrome: Observations in 50 Personally Observed Cases ,  Am. J. Med. , to be published.
Soffer, L. J.; Eisenberg, J.; Iannaccone, A., and Gabrilove, J. L.:  Cushing's Syndrome, in The Human Adrenal Cortex ,  A Ciba Foundation Colloquium on Endocrinology 8:487, 1955.
Mencher, W. H.:  Perirenal Insufflation ,  J.A.M.A. 109:1338, 1937.Crossref
Biel, L., Jr., and Eliasoph, J. L.:  A Technique for Retrorectal Gas Insufflation ,  J. Urol. 72:1255, 1954.