Ectopic adrenal tissue associated with borderline mucinous cystadenoma of ovary: a case report with review of the literature

Chew, Kah Teik; Abu, Muhammad Azrai; Arifuddin, Yulianty; Ismail, Napsiah; Nasir, Noor Ain Mohd; Mohammed, Faten F.; Azurah, Abdul Ghani Nur

doi:10.1515/hmbci-2017-0021

Cited by 8 publications

(5 citation statements)

References 13 publications

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“…One study revealed that not only does postoperative chemotherapy not necessarily improve patients' prognosis, but it can also lead to complications and increase the mortality rate. Therefore, chemotherapy is generally not recommended [11,12]. The investigators believe that it is necessary to be cautious about only operating on patients conservatively, and stress that follow-up after the operation is essential, and a radical operation should be considered as early as possible after the birth of a child.…”

Section: Discussionmentioning

confidence: 99%

Recurrence characteristics and clinicopathological results of borderline ovarian tumors

Niu

Tian

et al. 2021

BMC Women's Health

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Background This study aimed to investigate the clinical and pathological characteristics, and the recurrence and prognostic factors of borderline ovarian tumors (BOTs). Methods The data of 286 patients admitted to hospital and followed up for more than ten months were analyzed retrospectively to study the clinicopathological characteristics and related factors of recurrence. Results The median age of the patients was 42.06 ± 14.97 years, and the duration of the follow-up ranged from 10–109 months. During the follow-up period, 40 patients had a recurrence. Of these patients, 36 were ≤ 40 years, and patients with premenopausal recurrence accounted for 20.5% (36/176). In patients undergoing conservative treatment or radical operations, the recurrence rates were 21.3% and 1.8%, respectively, and they were 13.4% (36/268) in patients at Federation International of Gynecology and Obstetrics (FIGO) stage I, and 22.2% (4/18) in patients at an advanced stage. Postoperative pathology revealed that 40 patients had micropapillary tumors, among whom ten patients (25%) had a recurrence, and 19 patients had complications with interstitial infiltration. Of these 19 patients, six had a recurrence (31.5%). Another 22 patients had complications with calcified sand bodies; among these, eight patients (36.4%) had a recurrence. All the differences were statistically significant (P < 0.05). There were four cancer-related deaths during the follow-up period. Late FIGO stage, conservative operation, and a high level of carbohydrate antigen 125 (CA125) were independent risk factors for the recurrence of BOTs. Conclusion BOTs usually occur in women under 40 years, have an occult onset, and half of the patients have no obvious clinical manifestations. Serum CA125 level can be used as a tumor marker to detect BOTs and the risk of its recurrence. Operation mode and FIGO stage are important independent factors for the recurrence of BOTs.

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Section: Discussionmentioning

confidence: 99%

Recurrence characteristics and clinicopathological results of borderline ovarian tumors

Niu

Tian

et al. 2021

BMC Women's Health

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“…In surgical pathology, most adrenal rests are discovered as incidental microscopic findings in various surgical specimens including kidneys or gonads (particularly, spermatic cord [22], rete testis [23][24][25], epididymis [26], ovary/paraovarian [22,[27][28][29][30][31][32][33], salpinx and parasalpinx [22,34,35] ). A recent surgical series from adults identified ectopic adrenal rests in both males and females with a more frequent Fig.…”

Section: Question 2: Why Do Pathologists Need To Know Ectopic or Hete...mentioning

confidence: 99%

Overview of the 2022 WHO Classification of Adrenal Cortical Tumors

et al. 2022

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The new WHO classification of adrenal cortical proliferations reflects translational advances in the fields of endocrine pathology, oncology and molecular biology. By adopting a question–answer framework, this review highlights advances in knowledge of histological features, ancillary studies, and associated genetic findings that increase the understanding of the adrenal cortex pathologies that are now reflected in the 2022 WHO classification. The pathological correlates of adrenal cortical proliferations include diffuse adrenal cortical hyperplasia, adrenal cortical nodular disease, adrenal cortical adenomas and adrenal cortical carcinomas. Understanding germline susceptibility and the clonal-neoplastic nature of individual adrenal cortical nodules in primary bilateral macronodular adrenal cortical disease, and recognition of the clonal-neoplastic nature of incidentally discovered non-functional subcentimeter benign adrenal cortical nodules has led to redefining the spectrum of adrenal cortical nodular disease. As a consequence, the most significant nomenclature change in the field of adrenal cortical pathology involves the refined classification of adrenal cortical nodular disease which now includes (a) sporadic nodular adrenocortical disease, (b) bilateral micronodular adrenal cortical disease, and (c) bilateral macronodular adrenal cortical disease (formerly known primary bilateral macronodular adrenal cortical hyperplasia). This group of clinicopathological entities are reflected in functional adrenal cortical pathologies. Aldosterone producing cortical lesions can be unifocal or multifocal, and may be bilateral with no imaging-detected nodule(s). Furthermore, not all grossly or radiologically identified adrenal cortical lesions may be the source of aldosterone excess. For this reason, the new WHO classification endorses the nomenclature of the HISTALDO classification which uses CYP11B2 immunohistochemistry to identify functional sites of aldosterone production to help predict the risk of bilateral disease in primary aldosteronism. Adrenal cortical carcinomas are subtyped based on their morphological features to include conventional, oncocytic, myxoid, and sarcomatoid subtypes. Although the classic histopathologic criteria for diagnosing adrenal cortical carcinomas have not changed, the 2022 WHO classification underscores the diagnostic and prognostic impact of angioinvasion (vascular invasion) in these tumors. Microscopic angioinvasion is defined as tumor cells invading through a vessel wall and forming a thrombus/fibrin-tumor complex or intravascular tumor cells admixed with platelet thrombus/fibrin. In addition to well-established Weiss and modified Weiss scoring systems, the new WHO classification also expands on the use of other multiparameter diagnostic algorithms (reticulin algorithm, Lin–Weiss–Bisceglia system, and Helsinki scoring system) to assist the workup of adrenal cortical neoplasms in adults. Accordingly, conventional carcinomas can be assessed using all multiparameter diagnostic scheme...

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“…Because the adrenal primordium is separated from the adrenal-gonadal primordium, areas involved in the gonad such as the spermatic cord are frequent sites of ectopic adrenal tissue. Some reports show that ectopic adrenal tissue is observed in inguinal hernia surgeries (2) and in resected ovarian tumors (8). These reports indicate that ectopic adrenal tissue usually contains only the adrenal cortex and is found accidentally.…”

Section: Discussionmentioning

confidence: 99%

Pheochromocytoma arising from an ectopic adrenal tissue in multiple endocrine neoplasia type 2A

Ohsugi

Takizawa

Kinoshita

et al. 2019

Endocrinology, Diabetes &Amp; Metabolism Case Reports

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Summary A 21-year-old woman was referred to our hospital to treat bilateral pheochromocytomas (PCCs) after a diagnosis of multiple endocrine neoplasia type 2A (MEN2A). We performed bilateral laparoscopic adrenalectomy. One year after the operation, urinary fractionated metanephrines in 24-h urine increased. MRI showed a 30 mm tumor on the interaortocaval region and 123I-MIBG concentrated in this area. We excised the tumor and performed para-aortic lymphadenectomy. Histopathologic examination confirmed a PCC arising from ectopic adrenal tissue. Urinary fractionated metanephrines in 24-h urine declined to basal levels immediately after the operation. We detected no recurrence of paraganglioma or PCC for 5 years after the treatment. Learning points: Most ectopic adrenal tissue is associated with no symptoms and contains only the adrenal cortex. Adrenocortical tumors sometimes arise from ectopic adrenal tissues similarly to in the normal adrenal gland. PCC arising from ectopic adrenal tissue occurs infrequently. MEN2-related PCC is accompanied by adrenal medullary hyperplasia, which might be part of tumorigenesis.

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Ectopic adrenal tissue associated with borderline mucinous cystadenoma of ovary: a case report with review of the literature

Cited by 8 publications

References 13 publications

Recurrence characteristics and clinicopathological results of borderline ovarian tumors

Recurrence characteristics and clinicopathological results of borderline ovarian tumors

Overview of the 2022 WHO Classification of Adrenal Cortical Tumors

Pheochromocytoma arising from an ectopic adrenal tissue in multiple endocrine neoplasia type 2A

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