A Man With a Horseshoe Adrenal Gland Associated With a Midline Posterior Diaphragmatic Defect

Abstract

We present a case of a horseshoe adrenal gland and a posterior midline diaphragmatic defect found incidentally on computed tomography in a 60-year-old man. It is, to our knowledge, the first case in an adult and represents a relatively innocuous developmental abnormality when compared with the previously described fetal and infantile adrenal fusion syndrome. This case demonstrates the importance of cross-sectional imaging and the effectiveness of computed tomography in defining the spectrum of congenital anomalies.

Butterfly adrenal gland with maldevelopment of the mesonephric duct: A rare association in an adult patient

“…and Feldmann et al. [3] , [13] . These authors emphasized a similar embryologic precursor, anatomy, and temporal development of adrenal glands and diaphragma.…”

“…Only 4 cases of horseshoe adrenals in asymptomatic adult patients are reported in the literature [3] , [13] , [14] , [15] . The first case of an adult patient with horseshoe adrenal glands was detected via CT imaging by Feldmann and colleagues in 2009 [13] . They also detected a posterior midline diaphragmatic anomaly in their patient.…”

Horseshoe adrenal gland associated with type 1 diastematomyelia in an asymptomatic adult

“…It is postulated that its existence is due to a failure of midline structures to separate while another theory states that it is due to a failure of laterality because of a disturbed pattern of formation during blastogenesis. 1 This rare congenital anomaly is associated with multiple malformations that involve the cardiovascular, genitourinary and central nervous system. Among them, the most common reported one is asplenia (52%), followed by neural tube defects (37%), renal abnormalities (29%) and diaphragmatic defects (1%).…”

“…It is a finding documented almost exclusively in fetal, neonatal and infant autopsy studies and to date, there have only been a total of six prior cases reported in adults. 1–6 It is often found incidentally on imaging, e.g. ultrasound, CT or MRI in otherwise asymptomatic adults.…”

Adrenal Gland

“…Six cases of fused adrenal gland were reported in 3537 pediatric-perinatal autopsy cases (Klatt et al 1998). A horseshoe-shaped adrenal gland was incidentally found in a 60-year-old man (Feldmann et al 2009). A horseshoe-shaped adrenal gland was incidentally found in a 60-year-old man (Feldmann et al 2009).…”