Adrenal neuroblastomas are malignant neoplasms arising from the sympathetic neuroblasts in the medulla of the adrenal gland.1 There are two clinical types, based on the differences in distribution of metastasis, with overlapping of the two in a small percentage of cases. The first type was described by Pepper2 in 1901. It occurs in the stillborn and in young infants. The neoplasm invades the liver and regional lymph nodes, then the lungs, and late in the course, the calvarium and other flat bones. The second type was described by Robert Hutchinson3 in 1907. The Hutchinson type is characterized clinically by secondary growth in the orbit, meninges, skull and long bones and occurs in children up to 15 years of age, the largest number occurring in children between the ages of 2 and 3.
A review of some 200 cases reveals no true differences in the two types of
CLARK WC. ADRENAL NEUROBLASTOMA, WITH PARTICULAR REFERENCE TO METASTASIS TO THE ORBIT: REPORT OF A CASE AND NOTES ON TWO OTHER CASES. Arch Ophthalmol. 1939;22(4):575–580. doi:10.1001/archopht.1939.00860100059004
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