ADRENOCORTICAL ADENOMA PROBALY ARISING IN THE ACCESSORY ADRENAL-REPORT OF A CASE-

Usual adrenocortical adenoma is a common disease involving in Cushing's syndrome, but ectopic adrenocortical adenoma in the abdomen is extremely rate so far as we could review. Recently we experienced a case of huge adrenocortical adenoma arised in the accessory adrenal which was successfully resected. A 74-year-old woman was emergently admitted to the hospital because of acute abdomen with a shock state in September, 1994. CT and magnetic resonance imaging revealed a retroperitoneal tumor 18cm in size with a small quantity of intraperitoneal bleeding and hemorrhage in the tumor. After observation of the clinical course conservatively, an angiography visualized entering arteries (lumbar arteries L2_??_5) to the tumor and a vein (inferior vena cava) coming from it in February, 1995. In March, 1995, a surgical excision of the tumor was performed. The excised tumor was 18cm in size and histopathologically adrenocortical adenoma. The adrenal cortex originates from mesodermal peritoneal epithelium like the kidney, and hence, it is genetically rare that adrenocortical adenoma appears ectopically.