SUBTOTAL ADRENALECTOMY FOR CUSHING'S SYNDROME

OUR EXPERIENCE at the Mayo Clinic now covers 46 cases in which subtotal adrenalectomy has been performed for Cushing's syndrome. A brief review of the activities of our medical and surgical colleagues at the Mayo Clinic in studies of abnormalities of adrenal cortex function, as related to the adrenogenital syndrome and Cushing's syndrome, seems worth while.

My interest in abnormally functioning lesions of the adrenal gland dates back to 1924, when Keyser and I¹ reported a case of carcinoma of the adrenal gland with endocrine disturbances. The patient died of adrenal cortex insufficiency after removal of the large cancerous tumor. At postmortem examination a small atrophic adrenal gland was found on the opposite side. We have since found that an atrophic gland usually exists on the side opposite a unilateral hyperfunctioning benign or malignant tumor of the adrenal cortex and that adrenal replacement therapy is essential in the preoperative