MR appearance of an ectopic intraspinal adrenal cortical adenoma.

An ectopic adrenal cortical adenoma presented as an intradural spinal mass in an 8-year-old girl with bilateral leg pain. The patient had no endocrine symptoms of an adrenal adenoma despite abnormally high levels of androstenedione found within the tumor. The purpose of this article is to highlight the diagnostic radiologic aspects of this unusual neoplasm. The adrenal cortex develops from the coelomic mesoderm in the fourth to sixth week of life as a cluster of cells between the root of the mesentery and the genital ridge [1). Aberrant adrenal cortical tissue can migrate with gonadal tissue and has been described in a subcapsular location within the testes and ovaries [2] . Adrenal rest tumors have been described in the testes, particularly in patients with endocrine disturbances associated with increased levels of adrenocorticotropic hormone [3]. Sites of adrenal cortical ectopia also include the mediastinum, retroperitoneal space, pancreas, and kidney [4, 5]. There are two reports of intracranial adrenal glands containing both cortical and medullary tissue [6, 7]. However, ectopic adrenal cortical tissue with or without neoplasia within the spinal canal has not been reported before. Spinal ectopic renal tissue has been reported in a patient with spinal dysraphism [8].