J Neurol Surg A Cent Eur Neurosurg 2020; 81(01): 071-074
DOI: 10.1055/s-0038-1676595
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Adrenal Cortical Adenoma in the Spinal Canal: A Case Report and Review of the Literature

Jakob Nemir
1   Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
,
Martina Štenger
2   Department of Neurosurgery, Children's Hospital Zagreb, Zagreb, Croatia
,
Antonia Jakovčević
3   Department of Pathology, University Hospital Center Zagreb, Zagreb, Croatia
,
Ivan Domazet
1   Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
,
Niko Njirić
1   Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
,
Josip Paladino
1   Department of Neurosurgery, University Hospital Center Zagreb, Zagreb, Croatia
› Author Affiliations
Further Information

Publication History

03 April 2018

17 October 2018

Publication Date:
24 May 2019 (online)

Abstract

Ectopic adrenal cortical neoplasms of the spinal cord are extremely rare. To date only 10 such cases have been described. We present a case of a 46-year-old woman with lower back pain radiating to the right gluteal and posterior femoral regions, without a history of traumatic injury. Magnetic resonance imaging (MRI) of the thoracic and lumbar spine showed an intradural, extramedullary, well-circumscribed, contrast-enhancing lesion located in the T12–L1 region, hypo- to isointense on T2-weighted imaging, and isointense on T1. Complete surgical removal of the lesion, measuring 3 × 2.5 × 1 cm, was performed. The histopathologic findings revealed the lesion was an ectopic adrenal cortical adenoma, with sheets and nests of round and polygonal cells, mostly round regular nuclei, abundant eosinophilic cytoplasm, 1 mitosis per 10 high-power fields, and without necrosis. These tumors have nonspecific MRI features and therefore can be easily confused with other common spinal tumor types such as ependymoma, schwannoma, meningioma, and metastasis. Although rare, ectopic adrenal spinal cord adenomas should be taken into account in the differential diagnosis of spinal canal intradural neoplasms.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.


Informed Consent

Informed consent was obtained from all individual participants included in the study.


 
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