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Am J Dis Child. 1921;22(3):244-258. doi:10.1001/archpedi.1921.04120030023003.
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The subject of malignant tumors of the medulla of the suprarenal gland has received considerable attention during the last ten years. Since 1917, when Robert Hutchinson1 first brought the subject to the attention of clinicians and pathologists, a number of cases have been reported; it seems extraordinary that the clinical condition was not discussed in detail before that time, particularly in view of the character and of the uniqueness of the metastases.

The suprarenal gland, composed of medulla and cortex, embryologically is derived from two separate layers. The cortex is mesoblastic; the medulla is neuro-ectodermic, which layer also gives origin to the sympathetic system of nerves. Tumors of the cortex produce a symptomatology quite different from that produced by tumors of the medulla. The cortical neoplasms produce the syndromes described by Bullock and Sequeira,2 wherein there is premature sexual development, and by Guthrie and Emery3 in which


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