Adrenal Tissue in the Placenta: a Heterotopia Caused by Migration and Embolism?

Growth Patterns of Placental and Paraovarian Adrenocortical Heterotopias Are Different

“…Only six cases have been reported since Cox et al described the first case [12–16]. Table 2 summarizes the findings of previously reported cases and the current case.…”

“…Therefore, accessory or heterotopic adrenal cortical tissue is usually found in the retroperitoneal regions near the adrenal glands, kidneys, or along the descending tracts of the urogenital organs [18, 19]. Less common locations of adrenocortical heterotopia have been reported, such as within renal parenchyma [1–3], inside distant organs [4–11], and in the placenta [12–16]. Nonplacental origin of the heterotopia, including those near the urogenital tract and from distant organs, can be seen in any demographically diverse patient populations, adults, children, fetuses, and in both males and females.…”

“…In all cases, the heterotopias are from third trimester or term placentas of child-bearing-age women as incidental findings. Two cases are associated with twin placentas [15, 16]. The lesions are all solitary, ovoid, or round and range from less than 0.1 to 0.4 cm (average, 0.2 cm) in diameter.…”

“…Distant heterotopia is, however, not uncommon and can be found in many major organ systems including the kidneys [1–3], lungs [4, 5], brain or spinal cord [6, 7], and liver [8–11]. Demographically, adrenocortical heterotopia can be found in men and women, pediatric and adult patients, and fetus or even placenta [12–16]. According to a general review by Dr. Jaffe of New York [17], adrenocortical heterotopia may be present in as many as 50% of postmortems on males of “new born or very young infant” and in 50% of normal rats at sexual maturity in the epididymal region if cautiously searched for.…”

Heterotopic Nodules in the Placenta, an Immunohistochemical Re-evaluation of the Diagnosis of Adrenocortical Heterotopia

“…22 Rare microscopic nodules of adrenocortical tissue have been described in the human placenta. 1,2,6–10 Including the initial report in 1980 by Cox and Chavrier, 7 11 cases of adrenocortical heterotopia of the placenta have been reported in 7 manuscripts. Three of these reports have used immunohistochemistry on single cases to support the concept of adrenocortical differentiation, 1,2,10 the remaining 8 cases were diagnosed by morphology alone.…”