Overview
Accessory adrenal cortical tissue refers to ectopic adrenal cortical tissue located outside the normal adrenal glands. These findings are typically incidental and asymptomatic, though they can potentially undergo neoplastic transformation or contribute to hormonal imbalances.Diagnosis
Ectopic adrenal tissue is often an incidental finding on imaging studies performed for other indications.
Steroid assays, particularly in pediatric endocrinology, require careful consideration of specificity and concentration, with tandem mass spectrometry anticipated to improve clinical needs 1.
Recommendations exist for the surgical pathology reporting of adrenal cortical tumors 23.Management
Management is typically guided by whether the accessory tissue is associated with a hormonal abnormality or a neoplastic process.
Surgical resection may be considered for symptomatic lesions or those with concerning features on pathology 23.Special Populations
Pediatric patients present unique challenges for steroid analysis due to varying concentrations and the need for specific reference ranges 1.Key Recommendations
Clinicians and laboratories should maintain dialogue, especially when laboratory results do not align with clinical findings in steroid investigations 1.
Recommendations have been developed for the surgical pathology reporting of adrenal cortical tumors 23.
Quantitative steroid assays in pediatric endocrinology can be challenging, and immunoassays have known benefits and failings, with tandem mass spectrometry expected to meet clinical needs 1.References
1 Honour JW. Steroid assays in paediatric endocrinology. Journal of clinical research in pediatric endocrinology 2010. link
2 . Recommendations for reporting of tumors of the adrenal cortex and medulla. Association of Directors of Anatomic and Surgical Pathology. Human pathology 1999. link90240-x)
3 Lack EE. Recommendations for the reporting of tumors of the adrenal cortex and medulla. Association of Directors of Anatomic and Surgical Pathology. Virchows Archiv : an international journal of pathology 1999. link