Ectopic localisation of adrenal cortex

Souverijns, Geert; Peene, P; Keuleers, H; Vanbockrijck, Michel

doi:10.1007/s003309900263

Cited by 49 publications

(39 citation statements)

References 8 publications

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“…Ectopic adrenal tissue usually regresses in early infancy. 3 The adrenal cortex is developed from the coelomic mesoderm of the urogenital ridge during the 5th week of gestational age and separates from it during the 8th week. Ectopic adrenal tissue occurs when a fragment of the primitive adrenal gland sheds off during development.…”

Section: Discussionmentioning

confidence: 99%

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Intrarenal ectopic adrenal tissue and renal–adrenal fusion: a report of nine cases

Yoon

Epstein

2009

Modern Pathology

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Section: Discussionmentioning

confidence: 99%

“…Cases of both true ectopic intrarenal adrenal tissue and renal-adrenal fusion have been reported. [1][2][3][4][5][6] They are usually discovered incidentally in autopsies and surgical specimens and are of no clinical significance. However, in certain situations, adrenal heterotopia may pose a diagnostic challenge.…”

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confidence: 99%

Intrarenal ectopic adrenal tissue and renal–adrenal fusion: a report of nine cases

Yoon

Epstein

2009

Modern Pathology

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“…Typical locations are within the testes, the celiac plexus and along the spermatic cord (1)(2)(3)(4)(5)(6). Other rare locations are the liver and the spinal canal (7,8).…”

Section: Introductionmentioning

confidence: 99%

An adrenal rest tumour in the perirenal region in a patient with congenital adrenal hyperplasia due to congenital 3β-hydroxysteroid dehydrogenase deficiency

Grinten¹,

Duthoi²,

Otten³

et al. 2008

European Journal of Endocrinology

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Background: In contrast to the high incidence of testicular adrenal rest tumours (TART) in adult male patients with congenital adrenal hyperplasia (CAH), ovarian adrenal rest tumours in female CAH patients are very rare and other locations of adrenal rest tumours have never been reported. Here, we report on an adult patient with CAH due to 3b-hydroxysteroid dehydrogenase (HSD) deficiency with bilateral TART and additionally a large perirenal adrenal rest tumour. Case report: The patient was known with CAH due to 3b-HSD deficiency and treated with hydrocortisone and fludrocortisone since the neonatal period. In puberty, there was lack of compliance with consequently high POMC concentrations. At the age of 16 years, bilateral TART were detected by scrotal ultrasound. Intensifying glucocorticoid medication did not result in decrease in POMC concentrations and shrinkage of size of the tumours. At the age of 23 years, abdominal ultrasound was performed because of abdominal complaints, showing a round inhomogeneous structure with a diameter of 4 cm near the left renal hilus. A computer tomography scan showed a multinodular lesion in the retroperitoneal region beside the left kidney. Histological investigation after removal of the tumour showed sheets of large polygonal cells with abundant eosinophilic cytoplasm, separated by dense fibrous tissue strands. The histological and immunohistochemical profile resulted in a diagnosis of an adrenal rest tumour. Conclusion: In adult CAH patients, ectopic adrenal rest tumours can be present outside the testicular region. Further investigations are necessary to determine whether regularly screening for these tumours is useful.

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“…8 Macroscopically, the appearance of ectopic adrenal tissue is characteristic (a round, yellow nodule, firm in consistency, embedded in the cremasteric fibres, resembling a fat lobule).…”

Section: Discussionmentioning

confidence: 99%

“…7 However, the incidence of ectopic adrenal tissue in the spermatic cord of adults is significantly lower at 1%. 8 Macroscopically, the appearance of ectopic adrenal tissue is characteristic (a round, yellow nodule, firm in consistency, embedded in the cremasteric fibres, resembling a fat lobule). 1 Adrenal rests situated far from the original gland are composed entirely of cortical adrenal tissue with no evidence of medullary cells, but the more proximal cells may contain medulla.…”

Section: Discussionmentioning

confidence: 99%

Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male

Floyd

Itam

Nasir

et al. 2014

CUAJ

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Aberrant adrenal tissue near the adrenal gland is common, but the finding of ectopic adrenal tissue in structures around the spermatic cord and testis is rare. We describe a case of concomitant seminoma and ectopic adrenal tissue of the spermatic cord occurring in an adult patient who had undergone orchidopexy as a child. IntroductionAberrant adrenal tissue near the adrenal gland is common, but the finding of ectopic adrenal tissue in structures around the spermatic cord and testis remains rare. 1 In 1740, Morgagni first described ectopic adrenal tissue in the vicinity of the adrenal gland, 2 and in 1885 Dagonest noted the presence of adrenocortical tissue in the spermatic cord of an infant.3 Other non-adrenal sites include the coeliac axis, renal parenchyma, broad ligament and ovary; the placenta, hepatic, pulmonary and intracranial lesions, including eleventh cranial deposits, have also been described. 4,5 Case reportA 45-year-old male was referred to the outpatient department with a 3-month history of a painless right testicular mass. There was no history of trauma, recent infection, systemic upset or weight loss. His history was remarkable for essential hypertension and an inguinal orchidopexy at age 13 for an undescended right testicle. He had fathered 6 children.Physical examination revealed a soft non-tender abdomen with a right inguinal scar. There was a discreet mass in the upper pole of his right testicle, a right scrotal scar consistent with his orchidopexy and a normal left hemiscrotum. Tumour markers (alpha fetoprotein, beta human chorionic gonadotrophin and lactate dehydrogenase) were normal. Scrotal ultrasound demonstrated a 9-mm mass in the upper pole of the right testicle and a nodule in the right spermatic cord (Fig. 1). He underwent a right radical orchidectomy via his old inguinal scar. Final histopathological analysis revealed a classic seminoma, which stained positive for placental alkaline phosphatase (PLAP), but negative for Ber-H21, inhibin and Alphafeto protein (Fig. 2). No lymphovascular invasion was noted and it was staged as a pT1 lesion. The nodule in the spermatic cord contained morphological features consistent with an adrenal rest (Fig. 3). DiscussionIn the pediatric population, ectopic adrenal tissue found during inguinoscrotal procedures has been extensively documented 1,5 with a right-sided preponderance. There is an increased incidence of ectopic adrenal tissue within the spermatic cord of males with undescended testes, 5 ranging from 1.6% to 5.1%. 3,6 Autopsy series have shown an incidence of ectopic adrenal tissue adjacent to the native adrenal of up to 32% in adults.7 However, the incidence of ectopic adrenal tissue in the spermatic cord of adults is significantly lower at 1%. 8 Macroscopically, the appearance of ectopic adrenal tissue is characteristic (a round, yellow nodule, firm in consistency, embedded in the cremasteric fibres, resembling a fat lobule).1 Adrenal rests situated far from the original gland are composed entirely of cortical adrenal tissue with n...

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Ectopic localisation of adrenal cortex

Cited by 49 publications

References 8 publications

Intrarenal ectopic adrenal tissue and renal–adrenal fusion: a report of nine cases

Intrarenal ectopic adrenal tissue and renal–adrenal fusion: a report of nine cases

An adrenal rest tumour in the perirenal region in a patient with congenital adrenal hyperplasia due to congenital 3β-hydroxysteroid dehydrogenase deficiency

Concomitant testicular seminoma and ectopic adrenal tissue of the cord in a 45-year-old male

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