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

J Neurol Surg A Cent Eur Neurosurg. 2020 Jan;81(1):71-74. doi: 10.1055/s-0038-1676595. Epub 2019 May 24.


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.

Publication types

  • Case Reports

MeSH terms

  • Adrenocortical Adenoma / diagnostic imaging*
  • Adrenocortical Adenoma / pathology
  • Adrenocortical Adenoma / surgery
  • Female
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Lumbar Vertebrae / pathology
  • Lumbar Vertebrae / surgery
  • Magnetic Resonance Imaging
  • Middle Aged
  • Spinal Canal / diagnostic imaging*
  • Spinal Canal / pathology
  • Spinal Canal / surgery
  • Spinal Cord Neoplasms / diagnostic imaging*
  • Spinal Cord Neoplasms / pathology
  • Spinal Cord Neoplasms / surgery
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery
  • Treatment Outcome