Accessory adrenal cortex in the broad ligament.Incidence and functional significance

Abstract

ITH adrenalertomy increasingly employed W in the therapy of advanced breast and prostatic cancer, in Gushing's syndrome, and in certain cases of intractable hypertension,lB the problem of accessory adrenal tissue becomes of more than casual concern to the clinician. Relatively little attention has been paid to the incidence, location, and possible functional significance of adrenal rests in man. Known to occur not infrequently in fetuses and infants, they were until recently rarely encountered in adults, though sporadic cases have been reported in such diverse locations as the liver, kidney, pancreas, transverse colon, celiac-plexus area, periadrenal fat, broad ligament, ovary, testicle, epididymis, retroperitoneally along the course of the vessels to the gonads, and even a uterine leiomyoma.20 It is understandable that knowledge of this subject has been developed almost exclusively by pathologists, for these sites were relatively inaccessible to the clinician, even at surgery. Furthermore, the infrequency of their detection relegated them to the role of a pathological curiosity, the incidence being variably reported from 0.067 to 0.9 per cent, depending on the investigator and the area under consideration.lg In 1953, however, Graham reported accessory adrenals in the celiac-plexus area in thirty-two of 100 consecutive adult autopsies, a frequency in striking contrast to the previously reported rarity.